{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Thomas F Hudson","gend":0,"currentgend":"","add":"136 MAIN ST","city":"COLUMBIA FALLS","state":"ME","zip":"04623","dob":"1955-01-06","age":"","mstatus":"","insh":"10000075980","cliId":"","pno":"2075461372","cno":"","email":"chudson3@roadrunner.com","ename":"","eno":"","pphy":"MORRIS, ERIC D","ppno":"2074834502","pcpadd":"Harrington Family Health Center,50 East Main St","pcpcity":"Harrington","pcpstate":"ME","pcpzip":"04643","pcpcounty":"","pcpid":"","pcpname":"HARRINGTON FAMILY HEALTH CENTER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"136 MAIN ST","madd2":"","madd3":"","mcity":"COLUMBIA FALLS","mstate":"ME","mzip":"04623","pcpfaxno":"2074834778","pcpnpi":"1700411980","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6QP9C39WM38","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","N132","K5730","R5383","R748","R61","R350","R509","N400","D72820","D696","M2550","D709","Z139","N401","R3911","R3912","E785","L570","L578","L821","D649","Z48816","R918","Z0189","R319","R339","R338","N3281","R911","K639","T8141XA","L089","R933","Z86010"],"date":["2023-09-27","2023-09-03","2023-09-03","2023-09-27","2023-09-05","2023-09-02","2023-10-20","2023-09-02","2024-03-19","2023-09-05","2023-09-05","2023-09-03","2024-01-18","2023-11-21","2024-01-23","2023-10-20","2023-10-20","2024-05-17","2024-05-06","2024-05-06","2024-05-06","2024-05-17","2024-04-05","2024-05-17","2024-01-12","2024-01-11","2024-01-16","2024-01-23","2024-02-14","2024-03-22","2024-05-17","2024-06-28","2024-06-28","2024-06-18","2024-06-18"],"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":[["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Levofloxacin","500 MG","","Select","Select",""],["","","Cyclobenzaprine","5 MG","","Select","Select",""],["","","Tramadol","50 MG","","Select","Select",""],["","","Atorvastatin","40 MG","","Select","Select",""],["","","Hydroxyzine Pam","25 MG","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Losartan","100 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":""}]}]}