{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Peggy A Micue","gend":1,"currentgend":"","add":"392 OAK ST","city":"Oakland","state":"ME","zip":"04963","dob":"1950-01-30","age":"","mstatus":"","insh":"10000038858","cliId":"","pno":"2074657976","cno":"","email":"","ename":"","eno":"","pphy":"PHELPS, JULIE J","ppno":"","pcpadd":"Waterville Family Practice,31 Front St","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"WATERVILLE FAMILY PRACTICE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"392 OAK ST","madd2":"","madd3":"","mcity":"Oakland","mstate":"ME","mzip":"04963","pcpfaxno":"2078731186","pcpnpi":"1679562979","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1Q30PA2VW48","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M810","F0390","R17","F5101","H6692","H73892","J342","J324","I2699","I471","B351","L602","H7012","E806","Z0000","Z23","Z1331","L659","Z139","E7801","Z5181","Z79899","R040","H6123","H73822","Z7901","S90221A"],"date":["2023-11-20","2024-03-28","2023-04-10","2023-08-07","2023-04-20","2023-10-24","2023-04-20","2023-04-20","2023-08-07","2023-08-07","2024-01-26","2023-10-13","2023-10-24","2023-11-20","2023-12-15","2023-12-15","2023-12-15","2023-12-15","2023-12-15","2023-11-20","2024-03-28","2024-03-28","2024-04-25","2024-04-25","2024-04-25","2024-04-25","2024-05-17"],"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":[["","","Alendronate","10 MG","","Select","Select",""],["","","Xarelto","","","Select","Select",""],["","","Haloperidol","2 MG","","Select","Select",""],["","","Fluconazole","150 MG","","Select","Select",""],["","","Memantine","5 MG","","Select","Select",""],["","","Mirtazapine","7.5 MG","","Select","Select",""],["","","Morphine Conc","100 MG","","Select","Select",""],["","","Diltiazem","120 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":""}]}]}