{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James R Hagar","gend":0,"currentgend":"","add":"412 OLD COUNTRY RD","city":"BRYANT POND","state":"ME","zip":"04219","dob":"1951-09-30","age":"","mstatus":"","insh":"10000038075","cliId":"","pno":"2076652133","cno":"2076652133","email":"","ename":"","eno":"","pphy":"DARGIS, BOOTH R","ppno":"2077446444","pcpadd":"Western Maine Primary Care,8 Pikes Hill","pcpcity":"Norway","pcpstate":"ME","pcpzip":"04268","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY AND INTERNAL MEDIC","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"412 OLD COUNTRY RD","madd2":"","madd3":"","mcity":"BRYANT POND","mstate":"ME","mzip":"04219","pcpfaxno":"2077436306","pcpnpi":"1205290152","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8YR7U31RD64","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H401112","H401121","E119","Z23","Z0000","Z1211","Z0101","H5203","R5383"],"date":["2024-07-01","2024-07-01","2023-11-03","2023-11-03","2023-11-03","2023-11-17","2024-07-01","2023-11-22","2024-07-02"],"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":[["","","Gavilyte-G","","","Select","Select",""],["","","Omeprazole","10 MG","","Select","Select",""],["","","Tacrolimus 0.1 % Ointment Padagis","","","Select","Select",""],["","","Atorvastatin","20 MG","","Select","Select",""],["","","Halobetasol 0.05 % Ointment Padagis","","","Select","Select",""],["","","Onetouch Ultra","","","Select","Select",""],["","","Peg 3350\/Electrolytes","236 GM","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Clobetasol 0.05 % Ointment Taro","","","Select","Select",""],["","","Tacrolimus 0.1 % Ointment Encube","","","Select","Select",""],["","","Metformin","500 MG","","Select","Select",""],["","","Timolol Mal (Twice Daily) 0.5 % Ophth Sol","","","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":""}]}]}