{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Steven W Hewins","gend":0,"currentgend":"","add":"8 WOODSIDE DR","city":"SCARBOROUGH","state":"ME","zip":"04074","dob":"1955-12-05","age":"","mstatus":"","insh":"10000084386","cliId":"","pno":"2076507275","cno":"","email":"kks7252@gmail.com","ename":"","eno":"","pphy":"REYNOLDS, JOHN R","ppno":"2077672174","pcpadd":"39 WALLACE AVE,","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"41066143","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"8 WOODSIDE DR","madd2":"","madd3":"","mcity":"SCARBOROUGH","mstate":"ME","mzip":"04074","pcpfaxno":"2077618198","pcpnpi":"1861426272","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7F81EV6AD99","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R6889","I480","Z1283","I10","I4819","I3481","I340","F419","J45909","H1031","H6123","L570","L820","M47816","M5136","M5450","M6281","R293","Z7409","I4811","I483","Z0000","D6869"],"date":["2023-01-01","2023-05-11","2023-05-11","2024-06-04","2024-06-04","2023-07-05","2023-07-05","2023-07-07","2023-07-07","2023-07-11","2023-08-08","2023-12-05","2023-12-05","2024-01-12","2024-01-12","2024-04-03","2024-04-03","2024-04-03","2024-04-03","2024-04-30","2024-04-30","2024-06-04","2024-06-04"],"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",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Omeprazole","20 MG","","Select","Select",""],["","","Amlodipine","5 MG","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Colchicine","0.6 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Methylprednisolone","4 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Lisinopril","40 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":""}]}]}