{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Anita B Thomas","gend":1,"currentgend":"","add":"364 GARLAND RD","city":"CORINTH","state":"ME","zip":"04427","dob":"1953-12-12","age":"","mstatus":"","insh":"10000077677","cliId":"","pno":"2072853573","cno":"","email":"thomasfarmsecme@hotmail.com","ename":"","eno":"","pphy":"HARMON, ABIGAIL R","ppno":"2079073300","pcpadd":"St Joseph Internal Medicine,900 Broadway","pcpcity":"Bangor","pcpstate":"ME","pcpzip":"04401","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"364 GARLAND RD","madd2":"","madd3":"","mcity":"CORINTH","mstate":"ME","mzip":"04427","pcpfaxno":"2079071923","pcpnpi":"1760124085","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2T43NP7NC14","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R32","E785","I10","D649","Z0000","R5382","N3281","N8110","Z1231","J069","J029","R051","R6889","E538","Z09","Z96651","H43813","H11053","Z01812","Z13820"],"date":["2023-06-27","2023-07-15","2024-07-09","2023-06-29","2024-07-09","2023-06-29","2023-08-15","2023-08-15","2023-11-14","2024-01-04","2024-01-04","2024-01-04","2023-12-27","2024-02-20","2024-03-29","2024-03-29","2024-03-26","2024-03-26","2024-06-05","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":[["","","Myrbetriq","","","Select","Select",""],["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Pravastatin","20 MG","","Select","Select",""],["","","Imipramine Hcl","50 MG","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Diltiazem","120 MG","","Select","Select",""],["","","Comirnaty","","","Select","Select",""],["","","Tiadylt Er","","","Select","Select",""],["","","Amoxicillin\/Clav","875\/125 MG","","Select","Select",""],["","","Dexamethasone","4 MG","","Select","Select",""],["","","Losartan","100 MG","","Select","Select",""],["","","Omeprazole","20 MG","","Select","Select",""],["","","Oxybutynin","10 MG","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Prednisone","50 MG","","Select","Select",""],["","","Metronidazole","500 MG","","Select","Select",""],["","","Comirnaty 2023-2024","","","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":""}]}]}