{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Victoria L Stanley","gend":1,"currentgend":"","add":"46 LAGRANGE RD","city":"HOWLAND","state":"ME","zip":"04448","dob":"1956-04-17","age":"","mstatus":"","insh":"10000085363","cliId":"","pno":"2077325394","cno":"","email":"declined@02032026.com","ename":"","eno":"","pphy":"DUHAIME, LAYCEE L","ppno":"2077946700","pcpadd":"PO Box 99,","pcpcity":"Lincoln","pcpstate":"ME","pcpzip":"04457","pcpcounty":"","pcpid":"","pcpname":"HEALTH ACCESS NETWORK","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 39","madd2":"","madd3":"","mcity":"HOWLAND","mstate":"ME","mzip":"04448","pcpfaxno":"2077946777","pcpnpi":"1942679899","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3DP6P20RM59","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z1212","Z1211","D509","Z1231","N950","Z780","R6889","N9089","D259","R9389","Z01419","I10","N8502","E6609","Z6839","F411","E119","N884","C541","D696","E669","N838","M8580","D649","Z0000","Z13220"],"date":["2023-04-02","2023-04-02","2023-04-29","2023-04-13","2023-05-12","2023-06-14","2023-04-28","2023-05-12","2023-07-05","2023-05-12","2023-05-10","2024-07-01","2023-07-05","2023-06-01","2023-06-01","2023-06-08","2024-07-01","2023-05-12","2024-01-19","2023-06-08","2023-07-05","2023-07-05","2023-10-25","2024-07-01","2023-10-25","2024-07-01"],"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",""],["","","Onetouch Ultra 2","","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Ointment Encube","","","Select","Select",""],["","","Sertraline","50 MG","","Select","Select",""],["","","Onetouch Ultra","","","Select","Select",""],["","","Propranolol","10 MG","","Select","Select",""],["","","Amlodipine","10 MG","","Select","Select",""],["","","Prednisone","5 MG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Shingrix","","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Metformin","500 MG","","Select","Select",""],["","","Prevnar 20","","","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":""}]}]}