{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Peter W Kimball","gend":0,"currentgend":"","add":"46 DESTINEE LN","city":"Naples","state":"ME","zip":"04055","dob":"1954-01-19","age":"","mstatus":"","insh":"10000090709","cliId":"","pno":"6036510029","cno":"","email":"Pkimball72@roadrunner.com","ename":"","eno":"","pphy":"CHASE, SCOTT M","ppno":"","pcpadd":"582 ROOSEVELT TRAIL,","pcpcity":"WINDHAM","pcpstate":"ME","pcpzip":"04062","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"46 DESTINEE LN","madd2":"","madd3":"","mcity":"Naples","mstate":"ME","mzip":"04055","pcpfaxno":"","pcpnpi":"1760584007","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8RK2CH0YF91","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M5388","M9904","M9903","M5117","M9901","S161XXA","E119","H5213","H52223","H524","H43813","S39012A","Z23","R609","I493","L989","E1165","N401","M5450","G629","R6889","M5416","M9902","E1142","I10","M25541","M1811","Z79899","M5137","M47816","M4316","M47817","M48061","M5116","M4726","Z0000","M48062","H35033"],"date":["2023-06-08","2023-11-16","2023-11-16","2023-04-07","2023-11-16","2023-06-08","2024-06-18","2023-06-13","2023-06-13","2023-06-13","2024-06-18","2023-08-04","2023-09-21","2023-09-21","2023-09-21","2023-09-21","2024-01-03","2023-10-13","2024-03-08","2024-04-22","2023-10-27","2024-01-05","2023-11-16","2024-06-14","2024-06-14","2023-12-18","2024-01-03","2024-01-03","2024-01-05","2024-01-05","2024-01-05","2024-02-14","2024-04-02","2024-04-02","2024-03-08","2024-04-05","2024-07-03","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":[["","","Tradjenta","","","Select","Select",""],["","","Lovastatin","40 MG","","Select","Select",""],["","","Glipizide","10 MG","","Select","Select",""],["","","Hydrochlorothiazide","50 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Pregabalin","50 MG","","Select","Select",""],["","","Mnexspike","","","Select","Select",""],["","","Onetouch Ultra","","","Select","Select",""],["","","Trulicity","","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Metoprolol Succinate","","","Select","Select",""],["","","Metoprolol Succ","25 MG","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Jardiance","","","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":""}]}]}