{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Roderick O Babnaw","gend":0,"currentgend":"","add":"49 TROLLEY LINE DR","city":"MADISON","state":"ME","zip":"04950","dob":"1960-07-26","age":"","mstatus":"","insh":"10000116457","cliId":"","pno":2076967175,"cno":"","email":"Babnaw1@yahoo.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":"49 TROLLEY LINE DR","madd2":"","madd3":"","mcity":"MADISON","mstate":"ME","mzip":"04950","pcpfaxno":2074746930,"pcpnpi":1730196015,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6YQ4E79NA71","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":["G4733","Z0000","M961","I6521","Z87891","M51370","M4804","Z79899","H3551","L03311","M5124","Z01818","L02211","M79606","Z9689","Z98890","Z981"],"date":["2025-09-09","2025-04-10","2025-03-24","2025-04-18","2025-01-20","2024-12-04","2024-12-30","2025-05-28","2025-08-11","2025-06-27","2024-12-30","2024-12-30","2025-07-02","2024-10-16","2025-02-03","2025-02-03","2025-02-03"],"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":[["","","CITALOPRAM HBR","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","METOCLOPRAMIDE HCL","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","BISOPROLOL-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","OXYCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","TESTOSTERONE CYPIONATE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","VASCEPA","","","Select","Select",""],["","","XARELTO","","","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":""}]}]}