{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Deborah M Plummer","gend":1,"currentgend":"","add":"26 BACK RD","city":"FAIRFIELD","state":"ME","zip":"04937","dob":"1954-01-14","age":"","mstatus":"","insh":"10000065419","cliId":"","pno":"2072155670","cno":"2072155670","email":"debbiepdmp@yahoo.com","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"26 BACK RD","madd2":"","madd3":"","mcity":"FAIRFIELD","mstate":"ME","mzip":"04937","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5FK4A09EV02","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M722","M7732","M24572","M24571","N3946","R350","E669","Z6835","K219","B372","Z6839","M19011","M25511","K5900","Z6834","M75101","Z0000","E559","E663","M8580","B351","L608","Z538","Z1231","M810","R1310","M546","M542","H33311","H33312","H33303","H524","Z0101","H35363","H2513","H04123","H33313","R0789","R0602","L989","Z6831","Z136","K810","R1011","R109","Z09","K8510","H25813","M549","D123","Z86010","Z1211","D120","D125","Z9049","H9202","H6092"],"date":["2023-09-28","2023-09-28","2023-09-28","2023-09-28","2023-05-15","2023-05-15","2023-10-13","2023-05-15","2023-09-07","2023-06-27","2023-06-27","2023-07-10","2023-07-10","2023-07-31","2023-07-31","2023-07-10","2023-08-03","2023-08-03","2023-08-03","2023-08-03","2023-07-19","2023-07-19","2023-08-23","2023-09-07","2023-10-13","2023-09-07","2023-10-02","2023-10-02","2023-10-19","2023-10-20","2023-10-17","2023-10-17","2023-10-17","2023-10-17","2023-10-19","2023-10-19","2024-05-08","2023-10-06","2023-10-06","2024-05-28","2023-10-13","2023-10-06","2023-12-06","2024-05-14","2024-06-20","2023-12-06","2023-12-06","2024-05-08","2024-05-14","2024-06-04","2024-06-04","2024-06-04","2024-06-04","2024-06-04","2024-05-14","2024-06-19","2024-06-25"],"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":[["","","Prednisone","5 MG","","Select","Select",""],["","","Hydroxyzine Pam","25 MG","","Select","Select",""],["","","Fluticasone Prop","50 MCG","","Select","Select",""],["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Cyclobenzaprine","5 MG","","Select","Select",""],["","","Meclizine","25 MG","","Select","Select",""],["","","Bupropion Hcl","150 MG","","Select","Select",""],["","","Alendronate","70 MG","","Select","Select",""],["","","Ciproflox\/Dexameth 0.3\/0.1 % Otic Susp Sun","","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Ozempic","","","Select","Select",""],["","","Prevnar 20","","","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":""}]}]}