{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Christopher A Cooper","gend":0,"currentgend":"","add":"10 COOPER HILL RD","city":"WEST PARIS","state":"ME","zip":"04289","dob":"1950-07-26","age":"","mstatus":"","insh":"10000042380","cliId":"","pno":"2076743303","cno":"2076742200","email":"","ename":"","eno":"","pphy":"HARBAGE, PETER E","ppno":"2077446444","pcpadd":"193 MAIN ST,SUITE 1","pcpcity":"NORWAY","pcpstate":"ME","pcpzip":"42685645","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY AND INTERNAL MEDIC","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"2077445105","add2":"","add3":"","madd1":"27 BETHEL RD","madd2":"","madd3":"","mcity":"WEST PARIS","mstate":"ME","mzip":"04289","pcpfaxno":"2077436306","pcpnpi":"1124008784","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3QJ2N86XT29","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D696","Z01818","M160","M25551","Z96641","R338","M1611","I129","N1832","E6601","Z98890","T83011A","N400","I10","Z471","M7989","M109","N99112","N99111","G4730","E669","R4182","R399","N281","R339","Z0000","Z23","R7989","D7589","N5089","N503"],"date":["2023-11-02","2023-12-13","2023-12-13","2023-12-13","2024-03-05","2024-01-03","2024-01-03","2024-01-03","2024-03-04","2024-01-03","2024-01-03","2024-01-03","2024-02-21","2024-01-29","2024-01-31","2024-02-05","2024-02-05","2024-03-01","2024-03-01","2024-03-01","2024-03-01","2024-03-01","2024-03-20","2024-03-04","2024-06-12","2024-04-02","2024-04-02","2024-02-10","2024-02-10","2024-07-09","2024-07-09"],"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":[["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Metronidazole 0.75 % Gel Cosette","","","Select","Select",""],["","","Freestyle Lite","","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Tramadol","50 MG","","Select","Select",""],["","","Carvedilol","3.125 MG","","Select","Select",""],["","","Losartan","100 MG","","Select","Select",""],["","","Freestyle","","","Select","Select",""],["","","Shingrix","","","Select","Select",""],["","","Amlodipine","5 MG","","Select","Select",""],["","","Novolog Flexpen","","","Select","Select",""],["","","Lantus Solostar","","","Select","Select",""],["","","Allopurinol","100 MG","","Select","Select",""],["","","Indomethacin","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":""}]}]}