{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Stephen Krammes","gend":0,"currentgend":"","add":"20 MOONSTONE WAY","city":"Wells","state":"ME","zip":"04090","dob":"1950-12-25","age":"","mstatus":"","insh":"10000043895","cliId":"","pno":"6032753295","cno":"","email":"SKRAMMES50@YAHOO.COM","ename":"","eno":"","pphy":"DAVIES, DANIEL L","ppno":"6034338434","pcpadd":"Beacon Internal Medicine,155 Borthwick Ave W Bldg Ste 202","pcpcity":"Portsmouth","pcpstate":"NH","pcpzip":"03801","pcpcounty":"","pcpid":"","pcpname":"BEACON INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"20 MOONSTONE WAY","madd2":"","madd3":"","mcity":"Wells","mstate":"ME","mzip":"04090","pcpfaxno":"6034335196","pcpnpi":"1083683833","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2RF7RT4TF37","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N1832","I10","E119","N250","I2510","M7551","M109","Z713","E782","S76192A","Y999","M25562","S76192D","S82092A","S82092D","Z4789","M1712","J069","Z0101","M1832","Z0000"],"date":["2024-05-31","2024-05-31","2024-07-05","2024-05-31","2023-10-12","2023-05-12","2023-06-30","2024-03-25","2024-03-25","2023-07-21","2023-11-30","2023-10-05","2023-09-01","2023-10-05","2023-12-06","2023-11-02","2023-11-02","2024-01-04","2024-03-18","2024-05-23","2024-07-05"],"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":[["","","Lokelma","","","Select","Select",""],["","","Dutasteride","0.5 MG","","Select","Select",""],["","","Betamethasone Diprop 0.05 % Cream Zydus","","","Select","Select",""],["","","Accu-Chek Aviva Plus","","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","Accu-Chek Guide Me","","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Atorvastatin","80 MG","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Allopurinol","100 MG","","Select","Select",""],["","","Mometasone 0.1 % Cream G&W","","","Select","Select",""],["","","Mometasone 0.1 % Cream Padagis","","","Select","Select",""],["","","Arexvy","","","Select","Select",""],["","","Metoprolol Succ","25 MG","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Jardiance","","","Select","Select",""],["","","Metformin","500 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Accu-Chek Fastclix Lancet Drum (Ref 053601","","","Select","Select",""],["","","Sps Suspension","","","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":""}]}]}