{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Robert C Vilas","gend":0,"currentgend":"","add":"3 AMETHYST DR","city":"TOPSHAM","state":"ME","zip":"04086","dob":"1950-09-02","age":"","mstatus":"","insh":"10000074034","cliId":"","pno":"","cno":"2075229793","email":"rvilas@comcast.net","ename":"","eno":"","pphy":"DECK, MARCUS M","ppno":"2077984400","pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"3 AMETHYST DR","madd2":"","madd3":"","mcity":"TOPSHAM","mstate":"ME","mzip":"04086","pcpfaxno":"2077984018","pcpnpi":"1891717872","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3UE1WP7FJ09","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":["M9905","M5459","M9903","M5136","I480","I10","I2584","I77810","I6529","Z23","N401","Z125","R9720","M79674","M79675","B351","C4359","L570","D225","D492","D0359","L814","L821","Z872","I2510","R079","R42","Z0100","H25813","H5213","H52223","M25552"],"date":["2023-06-02","2023-06-02","2023-06-02","2023-06-02","2023-12-13","2023-12-13","2023-12-13","2023-12-13","2023-07-01","2023-10-16","2024-03-08","2023-11-17","2024-03-08","2023-12-21","2023-12-21","2023-12-21","2024-03-14","2024-02-20","2024-02-20","2024-02-20","2024-03-14","2024-02-20","2024-02-20","2024-02-20","2024-04-03","2024-04-03","2024-04-03","2024-06-27","2024-06-27","2024-06-27","2024-06-27","2024-07-12"],"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":[["","","Levofloxacin","500 MG","","Select","Select",""],["","","Atorvastatin Calcium","","","Select","Select",""],["","","Metoprolol Succinate","","","Select","Select",""],["","","Tramadol","50 MG","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Atorvastatin","20 MG","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Finasteride","5 MG","","Select","Select",""],["","","Comirnaty","","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Arexvy","","","Select","Select",""],["","","Bupropion Hcl","100 MG","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Cefpodoxime","200 MG","","Select","Select",""],["","","Amlodipine","2.5 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":""}]}]}