{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ruth H Oakley","gend":1,"currentgend":"","add":"211 RANDALL RD 62","city":"Lewiston","state":"ME","zip":"04240","dob":"1951-11-18","age":"","mstatus":"","insh":"10000055368","cliId":"","pno":"2072101089","cno":"","email":"RUTH.H.OAKLEY@GMAIL.COM","ename":"","eno":"","pphy":"ASSADOLLAHZADEH, MINA","ppno":"2077774440","pcpadd":"St Marys Center for Family Medicine,15 Mollison Way","pcpcity":"Lewiston","pcpstate":"ME","pcpzip":"04240","pcpcounty":"","pcpid":"","pcpname":"ST MARYS CENTER FOR FAMILY MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"211 RANDALL RD 62","madd2":"","madd3":"","mcity":"Lewiston","mstate":"ME","mzip":"04240","pcpfaxno":"2077778197","pcpnpi":"1487068698","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5AJ8PY6MQ30","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J209","Z0101","J8283","J4541","J0190","B9689","R7301","L570","J449","R6889","Z0000","E7849","J4520","R7303","D485","L814","Z85828","L821","Z1231","R051","R052","J988","C44311"],"date":["2023-05-01","2024-06-03","2024-03-18","2024-04-08","2023-05-31","2023-05-31","2023-07-03","2024-06-04","2023-10-11","2023-10-03","2023-10-11","2023-10-11","2023-10-11","2023-10-11","2024-06-04","2023-08-21","2024-06-04","2023-09-18","2024-03-08","2024-04-08","2024-05-08","2024-05-09","2024-06-04"],"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":[["","","Abrysvo Act-O-Vial","","","Select","Select",""],["","","Albuterol\/Ipratropium","3\/0.5 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Arnuity Ellipta","","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Montelukast","10 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":""}]}]}