{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joseph Smith","gend":0,"currentgend":"","add":"154 MAIN RD S","city":"HAMPDEN","state":"ME","zip":"04444","dob":"1956-08-09","age":"","mstatus":"","insh":"10000111118","cliId":"","pno":2072491192,"cno":"","email":"","ename":"","eno":"","pphy":"KARMES, AARON S","ppno":2079073777,"pcpadd":"St Joseph Family Medicine,900 Broadway","pcpcity":"Bangor","pcpstate":"ME","pcpzip":"04401","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH FAMILY MEDICINE HAMPDEN","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"154 MAIN RD S","madd2":"","madd3":"","mcity":"HAMPDEN","mstate":"ME","mzip":"04444","pcpfaxno":2079073778,"pcpnpi":1346503711,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5NY9F48YC48","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z471","M1712","M25562","S83282A","S83242A","X58XXXA","Z96652","Z01812","Z4889","Z01818","Z1211","D123","J45909","Z4789","K635"],"date":["2025-08-18","2025-08-18","2025-08-18","2024-07-16","2024-07-16","2024-07-16","2025-08-12","2025-04-14","2024-01-10","2025-04-08","2024-07-01","2024-07-01","2024-07-01","2024-02-20","2024-07-01"],"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":[["","","TESTOSTERONE CYPIONATE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","DIAZEPAM","","","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":""}]}]}