{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joan M Oxton","gend":1,"currentgend":"","add":"13 MARSHALL AVE","city":"Bath","state":"ME","zip":"04530","dob":"1952-04-28","age":"","mstatus":"","insh":"10000054601","cliId":"","pno":"2074428284","cno":"2077517581","email":"bjoxton@gwi.net","ename":"","eno":"","pphy":"FRENCH, SCOTT W","ppno":"2073861800","pcpadd":"Bath Internal Medicine,108 Centre St","pcpcity":"Bath","pcpstate":"ME","pcpzip":"04530","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"13 MARSHALL AVE","madd2":"","madd3":"","mcity":"Bath","mstate":"ME","mzip":"04530","pcpfaxno":"2074429822","pcpnpi":"1578564357","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1WF6K08JE46","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E119","I480","I471","I10","I729","Z4509","E041","Z1239","Z1231","E042","Z23","I671","J029","I4710","E785","Z0000","M6528","E1165","M25561","G8929","S42291A","S43004A"],"date":["2024-03-04","2023-07-20","2023-07-10","2024-03-19","2023-12-08","2023-07-20","2023-10-06","2023-09-11","2023-09-25","2023-10-06","2023-10-23","2023-12-08","2024-02-08","2024-03-19","2024-03-19","2024-04-18","2024-05-07","2024-06-25","2024-07-12","2024-07-12","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",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Mupirocin 2 % Ointment Padagis","","","Select","Select",""],["","","Cefadroxil","500 MG","","Select","Select",""],["","","Accu-Chek Smartview (Ref 06337538001)","","","Select","Select",""],["","","Metformin","500 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Ofloxacin 0.3 % Otic Sol Lifestar","","","Select","Select",""],["","","Tramadol","50 MG","","Select","Select",""],["","","Fluzone High-Dose","","","Select","Select",""],["","","Atorvastatin","40 MG","","Select","Select",""],["","","Comirnaty","","","Select","Select",""],["","","Onetouch Verio","","","Select","Select",""],["","","Duloxetine","60 MG","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Accu-Chek Fastclix Lancet Drum (Ref 053601","","","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":""}]}]}