{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Robert L Oreilly","gend":0,"currentgend":"","add":"158 CHURCH RD","city":"CLIFF ISLAND","state":"ME","zip":"04019","dob":"1948-07-12","age":"","mstatus":"","insh":"10000058986","cliId":"","pno":"2072727701","cno":"","email":"207lobsterman@gmail.com","ename":"","eno":"","pphy":"CLARK, DAVID E","ppno":"","pcpadd":"NMMC Medical Practices,194 E Main St Fl 1","pcpcity":"Fort Kent","pcpstate":"ME","pcpzip":"04743","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"14 BEVERLY TER","madd2":"","madd3":"","mcity":"Cape Elizabeth","mstate":"ME","mzip":"04107","pcpfaxno":"","pcpnpi":"1760910863","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7UJ8RD2HG31","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R0609","D509","I10","Z87891","R7401","D125","K5730","K648","K222","N1831","R630","R7989","D123","K219","R634","K2270","R748","F1090","Z0001","Z23"],"date":["2023-08-28","2023-07-28","2023-04-06","2023-04-06","2023-07-06","2023-07-17","2023-08-05","2023-07-17","2023-07-17","2023-07-28","2023-07-28","2023-07-28","2023-07-17","2023-07-17","2023-08-05","2023-08-21","2023-10-02","2023-08-21","2023-10-31","2023-10-08"],"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":[["","","Gavilyte-G","","","Select","Select",""],["","","Abrysvo Act-O-Vial","","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Lisinopril\/Hydrochlorothiazide","10\/12.5 MG","","Select","Select",""],["","","Omeprazole","20 MG","","Select","Select",""],["","","Peg 3350\/Electrolytes","236 GM","","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":""}]}]}