{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Bruce A Foss","gend":0,"currentgend":"","add":"48 SESAME ST","city":"Skowhegan","state":"ME","zip":"04976","dob":"1948-02-13","age":"","mstatus":"","insh":"10000090954","cliId":"","pno":2078585776,"cno":"","email":"annisroxanne@gmail.com","ename":"","eno":"","pphy":"DOUGHTY, MARK","ppno":2074740905,"pcpadd":"Redington Medical Primary Care,46 Fairview Ave Ste 111","pcpcity":"Skowhegan","pcpstate":"ME","pcpzip":"04976","pcpcounty":"","pcpid":"","pcpname":"REDINGTON MEDICAL PRIMARY CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"48 SESAME ST","madd2":"","madd3":"","mcity":"Skowhegan","mstate":"ME","mzip":"04976","pcpfaxno":2074746930,"pcpnpi":1730196015,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1AP2U80XQ11","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D72829","R918","Z739","J449","J4520","E113513","J188","E039","G4733","R251","S82451A","S0990XA","R296","R2681","J432","R911","I4710","S51002A","M5117","E1142","N281","Z0000","M79675","N320","M5116","J438","R1312","J189","J441","R6889","S32020A","S82831A","S82401D","J440","N289","J129","G894","D692","I119","M2550","E1143","M5450","N3941","Z79899","N401","M542","S199XXA","S3991XA","S3993XA","S299XXA","R55","R197","J439","H524","H2513","J159","R059","K219","Z23","G20C","G319","I499","R69","S86301A","I10","I2510","S82831D","S0093XA","Z87891","Z7951","S51012D","M79671","R0602","J471","R7989","S82434A","S99911A","M25571","J479","R4020","I672","R0902","E119"],"date":["2024-11-25","2025-01-17","2025-03-01","2025-11-01","2025-11-01","2024-10-18","2025-11-18","2024-07-09","2025-09-30","2025-01-15","2023-01-19","2024-11-03","2025-05-13","2023-12-14","2025-09-09","2025-10-07","2024-10-30","2024-01-19","2025-04-08","2025-07-18","2024-12-09","2025-05-01","2025-03-19","2024-05-23","2025-05-07","2024-04-01","2024-02-19","2025-03-12","2024-10-23","2025-10-01","2025-03-20","2022-12-08","2023-01-04","2024-11-01","2024-12-09","2024-10-11","2023-02-10","2024-10-18","2024-10-18","2024-10-18","2024-10-16","2025-03-20","2024-05-23","2024-05-23","2024-04-19","2024-11-03","2024-11-03","2024-11-03","2024-11-03","2024-11-03","2024-09-29","2022-11-29","2024-09-29","2024-03-19","2024-06-04","2024-10-15","2024-01-24","2023-10-27","2025-09-30","2025-03-06","2025-06-03","2024-11-19","2024-11-13","2022-12-08","2024-12-10","2024-11-20","2023-01-19","2024-09-29","2024-05-30","2024-05-30","2022-11-07","2022-11-12","2022-11-13","2022-11-16","2022-11-14","2022-11-12","2022-11-12","2022-11-12","2022-11-13","2022-11-08","2022-11-08","2022-07-22","2022-06-15"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Self-Assessment and Social History (SDOH)","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","","IPRATROPIUM-ALBUTEROL","","","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Assessment of Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}