{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Harry D Mckenna","gend":0,"currentgend":"","add":"5 FRYE DR","city":"CUMBERLAND","state":"ME","zip":"04021","dob":"1954-01-23","age":"","mstatus":"","insh":"10000066217","cliId":"","pno":"2073007760","cno":"","email":"hdmckenna@gmail.com","ename":"","eno":"","pphy":"BRENNAN, KATHLEEN E","ppno":"2077811500","pcpadd":"22 BRAMHALL ST,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41023134","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"5 FRYE DR","madd2":"","madd3":"","mcity":"CUMBERLAND","mstate":"ME","mzip":"04021","pcpfaxno":"2077811507","pcpnpi":"1922444900","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8HH9GQ4AR20","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z471","Z96652","Z96659","H40013","Z0101","I7121","I77810","Z98890","H903","H9313","I10","D1801","L814","L821","L853","Z0000","R5383","R7989","R310","N2889","I7120"],"date":["2023-04-05","2023-04-05","2023-04-05","2024-05-02","2024-05-02","2024-07-05","2023-08-21","2024-07-10","2023-11-10","2023-10-20","2023-11-01","2024-03-28","2024-03-28","2024-03-28","2024-03-28","2024-04-16","2024-05-01","2024-06-26","2024-06-26","2024-06-28","2024-07-05"],"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":[["","","Testosterone 1.62%","20.25 MG","","Select","Select",""],["","","Testosterone","50 MG","","Select","Select",""],["","","Potassium Cl","20 MEQ","","Select","Select",""],["","","Furosemide","40 MG","","Select","Select",""],["","","Amiodarone","200 MG","","Select","Select",""],["","","Testosterone 1%","50 MG","","Select","Select",""],["","","Fluzone High-Dose","","","Select","Select",""],["","","Ketoconazole 2 % Cream Fougera","","","Select","Select",""],["","","Metoprolol Tart","25 MG","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Metoprolol Succ","25 MG","","Select","Select",""],["","","Triamcinolone Acet 0.025 % Cream Padagis","","","Select","Select",""],["","","Atenolol","25 MG","","Select","Select",""],["","","Diltiazem","120 MG","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","Chlorhexidine 0.12 % Oral Rinse Xttrium","","","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":""}]}]}