{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Diann O Moseson","gend":1,"currentgend":"","add":"214 MEGQUIER HILL RD","city":"POLAND","state":"ME","zip":"04274","dob":"1951-06-09","age":"","mstatus":"","insh":"10000054914","cliId":"","pno":"2079983316","cno":"","email":"diannmoseson@yahoo.com","ename":"","eno":"","pphy":"JOHANNESSON, INGA S","ppno":"2077437721","pcpadd":"8 PIKES HL,","pcpcity":"NORWAY","pcpstate":"ME","pcpzip":"42685340","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY AND INTERNAL MEDIC","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 115","madd2":"","madd3":"","mcity":"WEST POLAND","mstate":"ME","mzip":"04291","pcpfaxno":"2077436306","pcpnpi":"1205863156","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4PM3ND7HX06","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E1165","E1140","Z0000","R6889","L0390","Z23","M79674","E119","I10","N1831","Z1231","H2513","H40053","R809","N189","E6601","N2889"],"date":["2023-04-11","2024-01-24","2023-07-14","2023-07-09","2023-09-25","2023-09-25","2023-10-18","2024-04-17","2024-01-16","2024-06-14","2024-02-16","2024-03-20","2024-03-20","2024-04-17","2024-04-17","2024-04-23","2024-06-14"],"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":[["","","Bd Nano 2 Gen","","","Select","Select",""],["","","Atorvastatin","40 MG","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Victoza Pen","","","Select","Select",""],["","","Glipizide","10 MG","","Select","Select",""],["","","Amlodipine","10 MG","","Select","Select",""],["","","Metoprolol Succ","100 MG","","Select","Select",""],["","","Omeprazole","20 MG","","Select","Select",""],["","","Insulin Aspart Protamine\/Aspart 70\/30 Unit","","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Jardiance","","","Select","Select",""],["","","Metformin","500 MG","","Select","Select",""],["","","Contour Next","","","Select","Select",""],["","","Lisinopril","40 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":""}]}]}