{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Walter A Robbins","gend":0,"currentgend":"","add":"69 LAFFIN RD","city":"FRANKFORT","state":"ME","zip":"04438","dob":"1958-10-31","age":"","mstatus":"","insh":"10000109667","cliId":"","pno":6038429663,"cno":"","email":"pa.hopepeddler@gmail.com","ename":"","eno":"","pphy":"PATTEN, JOHN L","ppno":2078620300,"pcpadd":"St Joseph Family Medicine Hampden,21 Western Ave","pcpcity":"Hampden","pcpstate":"ME","pcpzip":"04444","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH FAMILY MEDICINE HAMPDEN","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 69","madd2":"","madd3":"","mcity":"FRANKFORT","mstate":"ME","mzip":"04438","pcpfaxno":2077778800,"pcpnpi":1669577938,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6GK5FJ7FY65","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0101","H52221","I4891","I4581","R319","Z09","I480","H9193","G4733","Z1211","D120","D123","D124","M9902","M546","M9901","M542","L814","D1801","L821","Z7189","Z86010","K219","Z8719","R310","R000","I209","Z125","K6389","K2210","K449","K2990","L570","D2239","D225","D485","I110","R052","K319","K2270","I5020","D235","L905","I4819","Z0000","I10","R8289","Z79899","Z5181","M5442","I4892","I499","L820","R58","L538","R208","N200","R6884","M5450","G8929"],"date":["2025-01-13","2025-01-13","2024-05-10","2024-02-15","2025-09-11","2023-12-05","2025-02-19","2023-12-05","2025-01-08","2023-11-07","2023-11-07","2023-11-07","2023-11-07","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-05","2025-11-05","2025-11-05","2025-11-05","2023-11-09","2024-12-02","2023-11-08","2025-09-01","2023-11-09","2024-10-04","2025-09-04","2023-11-07","2023-11-07","2023-11-07","2023-11-07","2024-02-27","2024-02-05","2025-02-10","2024-11-25","2024-10-04","2024-12-02","2023-11-07","2023-11-07","2024-12-02","2024-11-25","2025-02-10","2024-03-25","2025-03-03","2025-03-03","2025-09-05","2024-06-17","2024-06-17","2025-02-17","2024-05-09","2024-05-10","2024-02-27","2024-02-27","2024-02-27","2024-02-27","2025-09-11","2023-10-03","2023-10-03","2023-10-03"],"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":[["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","AMIODARONE HCL","","","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":[]}},{"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":""}]}]}