{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Frank Almeida","gend":0,"currentgend":"","add":"302 BLACKSTRAP RD","city":"FALMOUTH","state":"ME","zip":"04105","dob":"1956-12-10","age":"","mstatus":"","insh":"10000092332","cliId":"","pno":"2074099038","cno":"","email":"fh72184@aol.com","ename":"","eno":"","pphy":"CONNOLLY, PATRICK J","ppno":"2078282402","pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"302 BLACKSTRAP RD","madd2":"","madd3":"","mcity":"FALMOUTH","mstate":"ME","mzip":"04105","pcpfaxno":"2078282425","pcpnpi":"1982655098","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5UW8RN5ER29","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":["R1310","R6330","E119","H353132","G20","H0014","H01003","H01006","H02831","H02412","Z135","R55","S0181XA","I10","G20B1","I4892","R079","R791","S069X9A","S199XXA","I358","S0180XA","R000","G20A1","R279","R269","E785","E669","Z23","I491","Z0101","H40013","G20A2","R339","R350","N200","Z1211","M5450"],"date":["2023-05-31","2023-05-31","2024-06-10","2024-06-14","2023-08-11","2023-10-24","2023-08-17","2023-08-17","2023-08-17","2023-10-24","2023-06-06","2023-11-14","2023-10-14","2024-06-10","2023-10-14","2023-10-13","2023-10-14","2023-10-13","2023-10-13","2023-10-13","2023-10-14","2023-10-13","2023-10-14","2023-12-12","2023-12-12","2023-12-12","2023-11-01","2023-11-01","2023-12-15","2023-11-13","2023-12-08","2023-12-08","2024-07-10","2024-02-14","2024-03-25","2024-03-25","2024-04-26","2024-06-10"],"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":[["","","Metformin","500 MG","","Select","Select",""],["","","Mnexspike","","","Select","Select",""],["","","Onetouch Ultra","","","Select","Select",""],["","","Simvastatin","40 MG","","Select","Select",""],["","","Comirnaty","","","Select","Select",""],["","","Rosuvastatin","10 MG","","Select","Select",""],["","","Levetiracetam","500 MG","","Select","Select",""],["","","Solifenacin","10 MG","","Select","Select",""],["","","Fluzone High Dose","","","Select","Select",""],["","","Lisinopril","20 MG","","Select","Select",""],["","","Doxazosin","2 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":""}]}]}