{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Susan E Benson","gend":1,"currentgend":"","add":"56 SINNOTT RD","city":"Arundel","state":"ME","zip":"04046","dob":"1954-05-20","age":"","mstatus":"","insh":"10000068088","cliId":"","pno":"2072050465","cno":"","email":"sbenson56@gmail.com","ename":"","eno":"","pphy":"SCHWEMM, HEATHER N","ppno":"2074678988","pcpadd":"SMHC Health Center Kennebunk,2 Livewell Dr North Tower","pcpcity":"Kennebunk","pcpstate":"ME","pcpzip":"04043","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY AND INTERNAL MEDIC","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"56 SINNOTT RD","madd2":"","madd3":"","mcity":"Arundel","mstate":"ME","mzip":"04046","pcpfaxno":"2078741483","pcpnpi":"1881655132","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6Q77G86UA36","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E119","E1169","Z5181","N3281","D329","D320","Z0101","H52223","H524","U071","M79671","S93601A","S63601A","S93401D","F330","E559","Z23","Z0000","Z1231","S6991XA","J302","Z9181","M549","M79603","I6523","S46812A","M5412","M4802","M50223","M47812","M4312"],"date":["2024-04-25","2023-08-23","2023-08-23","2023-08-23","2023-09-05","2023-09-05","2023-09-14","2023-09-14","2023-09-14","2023-10-30","2023-11-16","2023-11-16","2023-11-16","2023-12-11","2023-12-11","2024-04-30","2023-12-11","2024-01-22","2024-01-24","2024-04-25","2024-04-25","2024-04-25","2024-06-30","2024-06-30","2024-07-02","2024-06-30","2024-07-09","2024-07-09","2024-07-09","2024-07-09","2024-07-09"],"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":[["","","Fluticasone Prop","50 MCG","","Select","Select",""],["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Macleods","","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Diazepam","5 MG","","Select","Select",""],["","","Rosuvastatin","10 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Sertraline","50 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Ascend Labs","","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Oxybutynin","5 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":""}]}]}