{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Anthony K Adams","gend":0,"currentgend":"","add":"7 HASKELL RD","city":"NORTH YARMOUTH","state":"ME","zip":"04097","dob":"1948-08-09","age":"","mstatus":"","insh":"10000058108","cliId":"","pno":"2078294615","cno":"2073186823","email":"tonyadams@maine.rr.com","ename":"","eno":"","pphy":"DOBIESKI, STEVEN T","ppno":"2077745816","pcpadd":"InterMed,84 Marginal Way Ste 800","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04101","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"7 HASKELL RD","madd2":"","madd3":"","mcity":"NORTH YARMOUTH","mstate":"ME","mzip":"04097","pcpfaxno":"2078741483","pcpnpi":"1942279617","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8FN0VV9AN19","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K8689","R197","R140","R195","Z950","E039","N402","L570","Z85820","L578","D225","L821","Z45018","R350","E119","Z794","H47233","R1013","R112","R6881","D120","Z86010","K5730","L814","D485","Z23","L989","D049","Z0000","D0439","I2510","E785","I10","I442","Z85828"],"date":["2023-09-15","2023-04-03","2023-08-08","2023-04-03","2024-07-11","2024-07-11","2024-04-11","2024-05-09","2024-05-09","2024-05-09","2023-05-09","2023-11-09","2023-07-13","2023-12-22","2024-03-07","2023-10-12","2024-03-07","2023-09-15","2023-08-14","2023-08-14","2023-09-21","2023-09-21","2023-09-21","2023-11-09","2023-11-09","2023-11-13","2023-11-09","2023-11-09","2023-12-27","2024-01-23","2024-03-04","2024-03-04","2024-03-04","2024-05-02","2024-05-09"],"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",""],["","","Dorzolamide\/Timolol 2\/0.5 % Ophth Sol Sand","","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Amlodipine","5 MG","","Select","Select",""],["","","Ketoconazole 2 % Cream Encube","","","Select","Select",""],["","","Metformin","500 MG","","Select","Select",""],["","","Creon","","","Select","Select",""],["","","Sertraline","100 MG","","Select","Select",""],["","","Clindamycin","150 MG","","Select","Select",""],["","","Lisinopril","20 MG","","Select","Select",""],["","","Novolog Flexpen","","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Lantus Solostar","","","Select","Select",""],["","","Latanoprost 0.005 % Ophth Sol Greenstone","","","Select","Select",""],["","","Atenolol","25 MG","","Select","Select",""],["","","Synthroid","","","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":""}]}]}