{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael E Carter","gend":0,"currentgend":"","add":"229 TWO LAKES DRIVE","city":"MACHIAS","state":"ME","zip":"04654","dob":"1950-05-04","age":"","mstatus":"","insh":"10000058870","cliId":"","pno":"2074791267","cno":"2074791267","email":"Cartermc5450@gmail.com","ename":"","eno":"","pphy":"BARBEE, KRISTEN","ppno":"2075462391","pcpadd":"ONE MEDICAL CENTER DRIVE,","pcpcity":"BIDDEFORD","pcpstate":"ME","pcpzip":"04005","pcpcounty":"","pcpid":"","pcpname":"MILBRIDGE MEDICAL CENTER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 413","madd2":"","madd3":"","mcity":"MACHIAS","mstate":"ME","mzip":"04654","pcpfaxno":"2072846291","pcpnpi":"1215166533","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5EY2UJ3CP19","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L570","D225","L814","L821","Z08","L820","M160","M48061","M5432","M5431","R6889","H04123","M5136","Z981","M4820","M4317","M19011","Z471","Z96612","Z96611","M4185","E785","M47816","M5450","M40209","Z23","I2510","M25511","Z0000","M25852","M25851","Z96653","Z09","Z01810","K7689","Z01818","R053","M438X6","R059","H01021","H01024","R1319","R140","R198","M25551","M25552","K5900","R197","D120","K6389","Z85828","L298","L538","R208"],"date":["2023-05-04","2024-06-20","2024-06-20","2023-05-04","2024-06-20","2024-06-20","2024-01-31","2024-01-08","2023-05-04","2023-05-04","2023-05-04","2024-02-19","2024-06-10","2024-04-18","2023-10-16","2024-05-02","2023-08-04","2023-08-04","2023-08-04","2023-08-04","2023-08-11","2023-10-06","2024-04-18","2024-01-04","2024-01-08","2023-10-06","2023-10-06","2023-10-06","2023-10-06","2023-10-30","2023-10-30","2024-06-10","2024-01-31","2023-12-11","2023-11-17","2024-01-02","2024-01-02","2024-01-08","2024-01-04","2024-02-19","2024-02-19","2024-05-03","2024-06-12","2024-06-12","2024-06-10","2024-06-10","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2024-06-20","2024-06-20","2024-06-20","2024-06-20"],"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",""],["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Mirtazapine","7.5 MG","","Select","Select",""],["","","Cyclobenzaprine","10 MG","","Select","Select",""],["","","Tramadol","50 MG","","Select","Select",""],["","","Ondansetron","8 MG","","Select","Select",""],["","","Paxlovid","300\/100 MG","","Select","Select",""],["","","Ezetimibe","10 MG","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Arexvy","","","Select","Select",""],["","","Moderna Covid-19 Vaccine","","","Select","Select",""],["","","Rosuvastatin","20 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":""}]}]}