{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Victoria B Strong","gend":1,"currentgend":"","add":"2 RIDGEVIEW LANE","city":"Freeport","state":"ME","zip":"04032","dob":"1948-10-25","age":"","mstatus":"","insh":"10000035608","cliId":"","pno":"2074009354","cno":"","email":"VBSTRONG@GMAIL.COM","ename":"","eno":"","pphy":"CASSIN, JARED","ppno":"2077811600","pcpadd":"MMP Falmouth Internal Medicine,5 Bucknam Rd Ste 2B","pcpcity":"Falmouth","pcpstate":"ME","pcpzip":"04105","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"2 RIDGEVIEW LANE","madd2":"","madd3":"","mcity":"Freeport","mstate":"ME","mzip":"04032","pcpfaxno":"2077811609","pcpnpi":"1780094243","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3YR5GT6EE94","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B079","L820","B078","L821","L578","Z853","D0511","R928","H04123","R1031","K5732","K8020","N289","R1032","R6889","R109","R198","Z0000","Z1329","Z13228","Z130","Z13220","L570"],"date":["2023-09-29","2024-07-08","2023-06-26","2023-06-26","2023-06-26","2023-07-11","2023-07-11","2023-07-11","2023-11-10","2023-11-14","2023-11-14","2023-11-14","2023-11-14","2023-11-14","2023-04-04","2024-01-09","2024-01-09","2024-02-20","2024-04-02","2024-04-02","2024-04-02","2024-04-02","2024-07-08"],"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":[["","","Restasis","","","Select","Select",""],["","","Cefadroxil","500 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Tramadol","50 MG","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","Mnexspike","","","Select","Select",""],["","","Fluoxetine","20 MG","","Select","Select",""],["","","Metronidazole","500 MG","","Select","Select",""],["","","Cefpodoxime","200 MG","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Arexvy","","","Select","Select",""],["","","Ondansetron","4 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":""}]}]}