{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kevin S Royal","gend":0,"currentgend":"","add":"157 BOWERBANK RD","city":"SEBEC","state":"ME","zip":"04481","dob":"1959-02-04","age":"","mstatus":"","insh":"10000115008","cliId":"","pno":2075648677,"cno":"","email":"","ename":"","eno":"","pphy":"VANDERMAST, DIANA M","ppno":2079437752,"pcpadd":"PO BOX 1129,","pcpcity":"GREENVILLE","pcpstate":"ME","pcpzip":"44411129","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE MILO","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"157 BOWERBANK RD","madd2":"","madd3":"","mcity":"SEBEC","mstate":"ME","mzip":"04481","pcpfaxno":2076952329,"pcpnpi":1669423349,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2QE4WJ8PV50","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C155","I255","Z452","C159","Z0000","Z9049","Z87891","K429","Z5111","I2510","I10","E785","D696","R918","C160","Z4502","Z923","R1310","R634","C787","Z79899","I493","C158","I081","I77810","Z8501","J432","J8410","N289","K439","N400"],"date":["2025-03-10","2025-02-14","2024-11-14","2025-09-15","2024-09-27","2025-03-10","2025-03-10","2025-08-28","2024-11-12","2025-01-16","2025-01-16","2025-01-16","2024-05-07","2024-09-09","2024-12-04","2025-09-04","2025-03-10","2024-04-09","2024-04-09","2024-07-09","2024-07-09","2025-01-20","2024-05-15","2025-02-14","2025-02-14","2025-08-28","2025-08-28","2025-08-28","2024-05-17","2025-08-28","2025-08-28"],"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":[["","","SCOPOLAMINE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","RAMIPRIL","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","ONDANSETRON 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":""}]}]}