{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jane T Turner","gend":1,"currentgend":"","add":"305 PLEASANT POND RD","city":"TURNER","state":"ME","zip":"04282","dob":"1948-04-18","age":"","mstatus":"","insh":"10000069683","cliId":"","pno":"2072242880","cno":"2078314074","email":"MRSTURNER1948@GMAIL.COM","ename":"","eno":"","pphy":"DUQUETTE, ADAM","ppno":"2077847388","pcpadd":"190 STETSON RD,","pcpcity":"AUBURN","pcpstate":"ME","pcpzip":"42107813","pcpcounty":"","pcpid":"","pcpname":"FAMILY HEALTH CARE ASSOCIATES","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"305 PLEASANT POND RD","madd2":"","madd3":"","mcity":"TURNER","mstate":"ME","mzip":"04282","pcpfaxno":"2077952043","pcpnpi":"1679884522","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5Y62X48JR98","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z008","E119","I10","E669","Z0101","Z9841","H26491","H25812","E785","Z7984","Z0000","M85852","M8588","Z1231","L821","D225","L814","L280"],"date":["2023-06-01","2024-03-14","2024-03-14","2024-03-14","2023-11-14","2023-11-14","2023-11-14","2023-11-14","2023-12-05","2023-12-14","2023-12-14","2024-04-17","2024-04-17","2024-04-17","2024-06-17","2024-06-17","2024-06-17","2024-06-17"],"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":[["","","Verapamil","180 MG","","Select","Select",""],["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Atorvastatin","10 MG","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","Onetouch Ultra","","","Select","Select",""],["","","Glipizide","5 MG","","Select","Select",""],["","","True Metrix","","","Select","Select",""],["","","Healthmart True Metrix","","","Select","Select",""],["","","Losartan","100 MG","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Unilet Super-Thin (Ref At0575)","","","Select","Select",""],["","","Celecoxib","200 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":""}]}]}