{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Charles D Billings","gend":0,"currentgend":"","add":"99 JORDAN AVE","city":"BRUNSWICK","state":"ME","zip":"04011","dob":"1954-01-31","age":"","mstatus":"","insh":"10000079278","cliId":"","pno":"2078449175","cno":"","email":"cdb.maine@gmail.com","ename":"","eno":"","pphy":"RICHARDS, SAMANTHA","ppno":"2077984050","pcpadd":"Martins Point Health Care,331 Veranda St","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04103","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"99 JORDAN AVE","madd2":"","madd3":"","mcity":"BRUNSWICK","mstate":"ME","mzip":"04011","pcpfaxno":"2077984018","pcpnpi":"1689960114","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5R13UU1UK08","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":["C61","I352","G4750","G4752","R0683","I10","I7789","N400","K4020","N323","N429","I080","I77810","I2510","I719","K8020","N281","K429","D649","Q230","Q231","Z01818","Z952","Z48812","J90","J9811","G4730","K219","J181","I7121","I700","H25813","R918","Z95828","I350","H538","I6523","R42","H539","E782","Z954","I4891"],"date":["2024-04-17","2024-02-27","2023-06-23","2023-10-19","2023-09-26","2024-04-04","2023-11-16","2023-08-04","2023-08-04","2023-08-04","2023-08-04","2023-10-20","2023-10-20","2023-11-16","2023-11-30","2023-11-30","2023-11-30","2023-11-30","2024-01-02","2024-01-14","2024-01-14","2023-12-28","2024-04-04","2024-02-02","2024-01-15","2024-01-13","2024-01-12","2024-01-12","2024-01-15","2024-01-12","2024-01-12","2024-01-29","2024-02-02","2024-02-07","2024-01-12","2024-03-07","2024-03-07","2024-03-07","2024-03-07","2024-04-04","2024-06-03","2024-03-12"],"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":[["","","Furosemide","20 MG","","Select","Select",""],["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Mupirocin 2 % Ointment Taro","","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Lisinopril","5 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Fluoxetine","10 MG","","Select","Select",""],["","","Amiodarone","200 MG","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Cyclobenzaprine","5 MG","","Select","Select",""],["","","Metoprolol Tart","25 MG","","Select","Select",""],["","","Rosuvastatin","10 MG","","Select","Select",""],["","","Amitriptyline","10 MG","","Select","Select",""],["","","Comirnaty","","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Metronidazole","500 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":""}]}]}