{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"David A Emerson","gend":0,"currentgend":"","add":"1234 INDIAN RIVER RD","city":"ADDISON","state":"ME","zip":"04606","dob":"1955-12-12","age":"","mstatus":"","insh":"10000107677","cliId":"","pno":2075576200,"cno":2072636677,"email":"davidemerson012@gmail.com","ename":"","eno":"","pphy":"BARBEE, KRISTEN","ppno":2075462391,"pcpadd":"ONE MEDICAL CENTER DRIVE,","pcpcity":"BIDDEFORD","pcpstate":"ME","pcpzip":"04005","pcpcounty":"","pcpid":"","pcpname":"MILBRIDGE MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1234 INDIAN RIVER RD","madd2":"","madd3":"","mcity":"ADDISON","mstate":"ME","mzip":"04606","pcpfaxno":2072846291,"pcpnpi":1215166533,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3FD7NR2VT35","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K222","H9190","R1310","H52223","H524","Z0001","K224","K219","H2511","H25041","Z0000","G4733","E782","H02831","H02834","I4892","L439","I4891","R1314","H2512","I495","Z961","C44519","H353131","J189","I499","H833X3","H9113","D485","L578","L821","L570","R6889","H353111"],"date":["2023-12-06","2023-12-06","2025-08-26","2024-03-07","2024-03-07","2025-04-14","2024-07-11","2025-08-26","2024-01-03","2024-01-03","2025-04-14","2024-09-17","2024-03-12","2024-03-19","2024-03-19","2025-05-15","2024-12-16","2025-05-15","2024-01-30","2024-01-24","2025-07-11","2024-03-06","2024-04-03","2025-03-20","2025-04-02","2025-07-15","2024-04-30","2024-04-30","2024-12-16","2024-03-06","2024-03-06","2024-12-16","2023-12-18","2023-11-28"],"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":[["","","MOXIFLOXACIN","","","Select","Select",""],["","","AMIODARONE HCL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","MULTAQ","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"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":[]}]},{"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":""}]}]}