{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jim I Mcnaughton","gend":0,"currentgend":"","add":"628 QUAKER RIDGE ROAD","city":"LEEDS","state":"ME","zip":"04263","dob":"1949-10-31","age":"","mstatus":"","insh":"10000054419","cliId":"","pno":"2077406600","cno":"2077406600","email":"mcnaug101@aol.com","ename":"","eno":"","pphy":"RIVARD, GARY S","ppno":"2075243501","pcpadd":"180 CHURCH HILL RD,STE 1","pcpcity":"LEEDS","pcpstate":"ME","pcpzip":"42633418","pcpcounty":"","pcpid":"","pcpname":"DFD RUSSELL MEDICAL CENTER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"628 QUAKER RIDGE ROAD","madd2":"","madd3":"","mcity":"LEEDS","mstate":"ME","mzip":"04263","pcpfaxno":"2076476015","pcpnpi":"1194801993","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9HA6K30XQ51","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J329","L0390","Z87891","F17210","E7800","I10","D649","D126","M5136","J439","M546","D72829","Z0000","H2513","R6889","S61412A","W541XXA","Y9389","J209","J449","R0600","R059","J0100","M720","M65331"],"date":["2023-05-22","2023-06-21","2023-07-11","2023-07-11","2023-08-02","2024-03-25","2024-03-25","2023-08-02","2023-08-02","2024-04-23","2023-08-02","2024-03-25","2023-08-15","2023-10-19","2023-10-30","2023-12-26","2023-12-26","2023-12-26","2024-01-19","2024-02-02","2024-02-02","2024-02-02","2024-02-26","2024-06-18","2024-06-18"],"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":[["","","Doxycycline Monohydrate","100 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Hydrochlorothiazide","12.5 MG","","Select","Select",""],["","","Breo Ellipta","","","Select","Select",""],["","","Fluzone High-Dose","","","Select","Select",""],["","","Amlodipine","10 MG","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Oxybutynin","10 MG","","Select","Select",""],["","","Levofloxacin","750 MG","","Select","Select",""],["","","Cyclobenzaprine","10 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Sod Sulf\/Pot Sulf\/Mag Sulf","17.5\/3.13\/1.6 G","","Select","Select",""],["","","Diazepam","5 MG","","Select","Select",""],["","","Prevnar 20","","","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":""}]}]}