{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Randall C Palmer","gend":0,"currentgend":"","add":"7 ASH ST","city":"Gardiner","state":"ME","zip":"04345","dob":"1950-02-22","age":"","mstatus":"","insh":"10000022085","cliId":"","pno":"2075822596","cno":"","email":"palmer8167@roadrunner.com","ename":"","eno":"","pphy":"MURRAY JAMES, NATHAN R","ppno":"2076260606","pcpadd":"Hallowell Family Practice,9 Union St","pcpcity":"Hallowell","pcpstate":"ME","pcpzip":"04347","pcpcounty":"","pcpid":"","pcpname":"HALLOWELL FAMILY PRACTICE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 503","madd2":"","madd3":"","mcity":"Gardiner","mstate":"ME","mzip":"04345","pcpfaxno":"2076260022","pcpnpi":"1851376065","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6E53U15JP05","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R9089","R42","R2689","H81399","E785","Z0000","E663","Z6829","H8113","E032","Z23","R5383","D649","R1032","R051","I700","R059","R6889","E1122","Z08","I2510","I10","E7800"],"date":["2023-04-24","2023-06-16","2023-04-24","2023-04-24","2023-06-16","2023-06-16","2023-06-16","2023-06-16","2023-04-28","2024-06-05","2023-11-03","2024-05-21","2023-11-15","2023-11-15","2023-11-30","2023-11-30","2023-12-13","2023-12-30","2024-06-03","2024-03-04","2024-06-20","2024-06-20","2024-06-20"],"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":[["","","Peg 3350\/Electrolytes","420 GM","","Select","Select",""],["","","Fluticasone Prop","50 MCG","","Select","Select",""],["","","Levothyroxine","112 MCG","","Select","Select",""],["","","Atorvastatin","40 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Metoprolol Succ","25 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":""}]}]}