{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Bonnie M Kerrigan","gend":1,"currentgend":"","add":"20 JOY ST","city":"Springvale","state":"ME","zip":"04083","dob":"1948-06-16","age":"","mstatus":"","insh":"10000035471","cliId":"","pno":"8023733275","cno":"2076510304","email":"bonniekerrigan@gmail.com","ename":"","eno":"","pphy":"IFANTIDES, MELISSA M","ppno":"2074907998","pcpadd":"1 MEDICAL CENTER DR,","pcpcity":"BIDDEFORD","pcpstate":"ME","pcpzip":"40059422","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"20 JOY ST","madd2":"","madd3":"","mcity":"Springvale","mstate":"ME","mzip":"04083","pcpfaxno":"2074907999","pcpnpi":"1407992175","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7TM4ET7WR61","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N950","R300","L84","Z1231","R6889","Z0101","H25093","H5213","H524","H52223","Z0000","N841","M79674","M79675","B351","M2041","M2042"],"date":["2023-11-13","2023-09-18","2023-09-18","2023-09-18","2023-10-30","2023-10-30","2023-10-30","2023-10-30","2023-10-30","2023-10-30","2023-11-14","2023-11-13","2024-07-10","2024-07-10","2024-07-10","2024-07-10","2024-07-10"],"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",""],["","","Fluconazole","150 MG","","Select","Select",""],["","","Furosemide","40 MG","","Select","Select",""],["","","Potassium Cl","20 MEQ","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Losartan","25 MG","","Select","Select",""],["","","Comirnaty","","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Entresto","","","Select","Select",""],["","","Metronidazole 0.75 % Cream Viona Pharmaceu","","","Select","Select",""],["","","Klor-Con M20","","","Select","Select",""],["","","Arexvy","","","Select","Select",""],["","","Spironolactone","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":""}]}]}