{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Alison V Hill","gend":1,"currentgend":"","add":"3 LOBSTER COVE RD","city":"MONHEGAN","state":"ME","zip":"04852","dob":"1951-05-15","age":"","mstatus":"","insh":"10000063338","cliId":"","pno":"2075424105","cno":"","email":"AHILLARTIST@GMAIL.COM","ename":"","eno":"","pphy":"LAURENCE, ROBERT P","ppno":"2073013790","pcpadd":"760 COMMERICAL STREET,PO BOX 548","pcpcity":"ROCKPORT","pcpstate":"ME","pcpzip":"04856","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"3 LOBSTER COVE RD","madd2":"","madd3":"","mcity":"MONHEGAN","mstate":"ME","mzip":"04852","pcpfaxno":"2075942261","pcpnpi":"1871603795","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7HK8H46MT31","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H401131","E034","Z0000","E038","E7800","J45909","Z1211","M79673","G8929","R6889","M19012"],"date":["2023-06-07","2023-08-22","2023-09-01","2023-09-01","2023-09-01","2023-09-01","2023-09-12","2024-05-02","2024-05-02","2023-04-22","2024-06-21"],"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",""],["","","Latanoprost 0.005 % Ophth Sol B&L","","","Select","Select",""],["","","Armour Thyroid","","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","Timolol Mal (Twice Daily) 0.5 % Ophth Sol","","","Select","Select",""],["","","Advair Diskus","","","Select","Select",""],["","","Cefuroxime","250 MG","","Select","Select",""],["","","Calcitonin-Salmon 200 Units Nas Spray Par","","","Select","Select",""],["","","Shingrix","","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Arexvy","","","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":""}]}]}