{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"John F Gray","gend":0,"currentgend":"","add":"209 FORE RD","city":"ELIOT","state":"ME","zip":"03903","dob":"1943-12-06","age":"","mstatus":"","insh":"10000074183","cliId":"","pno":"2074389381","cno":"2074512922","email":"johdor434@gmail.com","ename":"","eno":"","pphy":"KUMIN, MICHAEL C","ppno":"2074519600","pcpadd":"789 CENTRAL AVE,","pcpcity":"DOVER","pcpstate":"NH","pcpzip":"38202526","pcpcounty":"","pcpid":"","pcpname":"WHP SOUTH BERWICK FAMILY PRACTICE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"209 FORE RD","madd2":"","madd3":"","mcity":"ELIOT","mstate":"ME","mzip":"03903","pcpfaxno":"","pcpnpi":"1184795205","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6KR9YH5YQ24","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J449","R918","I10","R350","H6121","N3941","Z8042","J45909","E7849","R0602","Z23","J4489","Z0101","R21","B029","B070","R059","Z20822"],"date":["2023-04-18","2023-04-18","2024-04-17","2024-01-02","2023-07-05","2024-01-02","2024-01-02","2023-10-19","2024-04-17","2023-12-01","2023-10-25","2024-04-16","2023-11-02","2023-12-28","2024-05-01","2024-02-06","2024-03-28","2024-03-28"],"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":[["","","Telmisartan","20 MG","","Select","Select",""],["","","True Metrix","","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Super Thin (Ref At 0535Ah)","","","Select","Select",""],["","","Sertraline","100 MG","","Select","Select",""],["","","Amitriptyline","50 MG","","Select","Select",""],["","","Onetouch Ultra 2","","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Lupin","","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Breo Ellipta","","","Select","Select",""],["","","Doxycycline Monohydrate","100 MG","","Select","Select",""],["","","Rosuvastatin","5 MG","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Tobramycin\/Dex 0.3\/0.1 % Ophth Susp Sandoz","","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Shingrix","","","Select","Select",""],["","","Valacyclovir","1 GM","","Select","Select",""],["","","Amlodipine","5 MG","","Select","Select",""],["","","Lisinopril","2.5 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Chlorthalidone","25 MG","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Sandoz","","","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":""}]}]}