{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Thomas M Buescher","gend":0,"currentgend":"","add":"96 LEDGEWOOD DR","city":"Falmouth","state":"ME","zip":"04105","dob":"1947-09-29","age":"","mstatus":"","insh":"10000035229","cliId":"","pno":"2076918129","cno":"","email":"thombuescher@gmail.com","ename":"","eno":"","pphy":"WADLAND, WILLIAM R","ppno":"2078282402","pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"96 LEDGEWOOD DR","madd2":"","madd3":"","mcity":"Falmouth","mstate":"ME","mzip":"04105","pcpfaxno":"2078287850","pcpnpi":"1154499002","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5UH7W68NC46","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":["H903","I081","I77810","I499","I2720","I4821","I420","I4891","I498","Z789","Z23","I5189","I2510","R008","E785","R9439","R931","Z7901","I340","M25811","M25812","M6281","M25511","M25512","R7989","D2261","D0439","D0422","H9313","D492","L570","L578","K635","Z1211","F419","R4182","D123","K6389","Z86010","Z0101","H35373","D225","L814","L821","D2272","I428","I517"],"date":["2023-11-02","2023-06-29","2023-06-29","2023-06-29","2023-06-29","2024-06-21","2024-06-21","2023-07-18","2023-07-18","2023-07-20","2023-09-13","2023-08-02","2024-06-21","2023-08-09","2024-02-02","2023-09-06","2023-09-25","2023-10-19","2024-06-21","2023-12-07","2023-10-05","2023-12-07","2024-01-29","2023-12-07","2023-10-19","2023-11-03","2023-11-03","2023-11-03","2023-11-02","2024-05-10","2024-05-10","2024-05-10","2024-02-02","2024-02-02","2024-02-02","2024-02-02","2024-02-02","2024-02-02","2024-02-02","2024-03-26","2024-03-26","2024-05-10","2024-05-10","2024-05-10","2024-05-10","2024-05-21","2024-05-21"],"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":[["","","Jardiance","","","Select","Select",""],["","","Peg 3350\/Electrolytes","420 GM","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Xarelto","","","Select","Select",""],["","","Rosuvastatin","20 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Oseltamivir","75 MG","","Select","Select",""],["","","Doxycycline Monohydrate","100 MG","","Select","Select",""],["","","Abrysvo W\/ Diluent Syringe","","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Comirnaty","","","Select","Select",""],["","","Metoprolol Succ","100 MG","","Select","Select",""],["","","Valsartan","40 MG","","Select","Select",""],["","","Tranexamic Acid","650 MG","","Select","Select",""],["","","Arexvy","","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Comirnaty 2023-2024","","","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":""}]}]}