{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Paul C Roy","gend":0,"currentgend":"","add":"16 BARRON AVE","city":"LEWISTON","state":"ME","zip":"04240","dob":"1957-02-21","age":"","mstatus":"","insh":"10000095240","cliId":"","pno":"2077541417","cno":"","email":"","ename":"","eno":"","pphy":"RABY, NATHAN C","ppno":"2079982100","pcpadd":"Community Health Center,364 Maine St","pcpcity":"Poland","pcpstate":"ME","pcpzip":"04274","pcpcounty":"","pcpid":"","pcpname":"CENTRAL MAINE FAMILY MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"16 BARRON AVE","madd2":"","madd3":"","mcity":"LEWISTON","mstate":"ME","mzip":"04240","pcpfaxno":"","pcpnpi":"1770528143","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6TH3YM1XT00","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J9801","R062","J40","M9901","M9902","M9904","M542","I10","E7800","R748","M7712","L989","Z8249","I700","Z136","Z0101","R519","F3162","Z0000","E782"],"date":["2023-05-02","2023-05-02","2023-05-02","2024-05-01","2024-05-01","2024-05-01","2024-05-01","2024-05-22","2023-09-18","2023-08-14","2023-08-14","2023-09-10","2023-10-05","2023-10-05","2023-10-05","2023-11-08","2024-03-01","2024-02-21","2024-02-21","2024-05-22"],"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":[["","","Bupropion Hcl","150 MG","","Select","Select",""],["","","Alfuzosin","10 MG","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Lorazepam","0.5 MG","","Select","Select",""],["","","Atorvastatin","80 MG","","Select","Select",""],["","","Lamotrigine","200 MG","","Select","Select",""],["","","Amlodipine","10 MG","","Select","Select",""],["","","Cyclobenzaprine","10 MG","","Select","Select",""],["","","Lisinopril","20 MG","","Select","Select",""],["","","Citalopram","40 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":""}]}]}