{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James F Rutherford","gend":0,"currentgend":"","add":"55 WILDES DISTRICT RD","city":"KENNEBUNKPORT","state":"ME","zip":"04046","dob":"1941-02-20","age":"","mstatus":"","insh":"10000011236","cliId":"","pno":"","cno":"2072297103","email":"JFOSTERRUTHERFORD@gmail.com","ename":"","eno":"","pphy":"NORTH, DANIEL K","ppno":"2074678988","pcpadd":"SMHC Health Center Kennebunk,2 Livewell Dr North Tower","pcpcity":"Kennebunk","pcpstate":"ME","pcpzip":"04043","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY AND INTERNAL MEDIC","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 1928","madd2":"","madd3":"","mcity":"KENNEBUNKPORT","mstate":"ME","mzip":"04046","pcpfaxno":"2074678969","pcpnpi":"1154826725","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2CF0U03UH09","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I25118","Z0100","Z1833","L814","L821","D2372","I700","H2513","H401131","G4733","R0602","Z45018","H2511","H401111","I10","E785","H2512","Z950","H401121","G4730","C44519","C44612","C44719","C44712","Z961","D492","L570","Z20822","J111","J329","J40","Z23","T8141XD","B349","I083","I77810","I7133","I7143","T8140XD","I7121","H3561","Z0101"],"date":["2024-05-09","2023-05-15","2023-05-17","2023-05-17","2023-05-17","2023-05-17","2023-06-15","2023-08-21","2024-03-28","2024-05-30","2023-08-29","2023-08-29","2023-11-02","2023-11-02","2024-04-25","2023-11-28","2023-11-28","2024-06-04","2023-11-28","2023-11-28","2023-12-20","2023-12-20","2023-12-20","2024-01-25","2023-12-20","2023-12-20","2024-05-29","2024-02-20","2024-02-20","2024-02-20","2024-02-20","2024-03-06","2024-02-29","2024-02-17","2024-04-10","2024-04-10","2024-04-09","2024-04-09","2024-03-12","2024-04-10","2024-03-28","2024-05-16"],"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":[["","","Mupirocin 2 % Ointment Teva","","","Select","Select",""],["","","Latanoprost 0.005 % Ophth Sol B&L","","","Select","Select",""],["","","Valacyclovir","1 GM","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Pacific","","","Select","Select",""],["","","Atorvastatin","80 MG","","Select","Select",""],["","","Ketoconazole 2 % Shampoo Viona Pharmaceuti","","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Isosorbide Mononitrate","30 MG","","Select","Select",""],["","","Trazodone","50 MG","","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":""}]}]}