{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joan L Scott","gend":1,"currentgend":"","add":"92 LOWD RD","city":"Cornish","state":"ME","zip":"04020","dob":"1937-09-21","age":"","mstatus":"","insh":"10000038601","cliId":"","pno":"2076254651","cno":"2076083901","email":"declined@112922.com","ename":"","eno":"","pphy":"ROVNER, ROBERT B","ppno":"2076753121","pcpadd":"Steep Falls Family Practice,PO Box 39","pcpcity":"Steep Falls","pcpstate":"ME","pcpzip":"04085","pcpcounty":"","pcpid":"","pcpname":"STEEP FALLS FAMILY PRACTICE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"2076253983","add2":"","add3":"","madd1":"92 LOWD RD","madd2":"","madd3":"","mcity":"Cornish","mstate":"ME","mzip":"04020","pcpfaxno":"2076753396","pcpnpi":"1902912371","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8KQ8XQ5YR44","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H40003","Z0101","K1121","A6920","E871","G43909","J384","I6523","M7989","L03211","H353131","H2513","H52223","H40013","R55","I517","I700","R0902","K449","G459","I480","F03B0","I10","I639","G8320","R531","H2511","R6889","H2512","R1030"],"date":["2023-05-31","2023-05-31","2023-06-11","2023-08-22","2023-08-24","2023-06-11","2023-06-10","2023-06-10","2023-06-10","2023-06-09","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-08-20","2023-08-19","2023-08-19","2023-08-19","2023-08-19","2023-08-20","2023-08-22","2023-08-22","2023-08-31","2023-08-19","2023-08-19","2023-08-19","2023-10-04","2023-04-17","2023-10-26","2023-11-27"],"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":[["","","Hydrochlorothiazide","12.5 MG","","Select","Select",""],["","","Lisinopril","5 MG","","Select","Select",""],["","","Amoxicillin\/Clav","875\/125 MG","","Select","Select",""],["","","Meclizine","25 MG","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Timolol Mal (Twice Daily) 0.25 % Ophth Sol","","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Sandoz","","","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":""}]}]}