{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Richard J Marcoux","gend":0,"currentgend":"","add":"5 HARVEST LANE","city":"Lewiston","state":"ME","zip":"04240","dob":"1956-08-26","age":"","mstatus":"","insh":"10000028023","cliId":"","pno":"2073125375","cno":"","email":"RICKMARCOUX@ROADRUNNER.COM","ename":"","eno":"","pphy":"TAN, EDWIN V","ppno":"2073303950","pcpadd":"PO BOX 7291,","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42437291","pcpcounty":"","pcpid":"","pcpname":"AUBURN MEDICAL ASSOCIATES","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"5 HARVEST LANE","madd2":"","madd3":"","mcity":"Lewiston","mstate":"ME","mzip":"04240","pcpfaxno":"2073303955","pcpnpi":"1629074240","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8FV2JC5QJ11","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E785","J4520","Z0000","I10","K219","M797","R079","R0789","R6889","S0036XA","S60561A","S60562A","W57XXXA"],"date":["2023-08-18","2023-06-07","2023-06-07","2023-08-18","2023-06-07","2023-06-07","2023-06-14","2023-08-18","2023-04-24","2023-08-26","2023-08-26","2023-08-26","2023-08-26"],"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":[["","","Amoxicillin","500 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Perrigo","","","Select","Select",""],["","","Cefadroxil","500 MG","","Select","Select",""],["","","Fluticasone Prop","50 MCG","","Select","Select",""],["","","Amitriptyline","50 MG","","Select","Select",""],["","","Losartan","25 MG","","Select","Select",""],["","","Mnexspike","","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Atorvastatin","20 MG","","Select","Select",""],["","","Amitriptyline Hcl","","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Arexvy","","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Amoxicillin\/Clav","875\/125 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":""}]}]}