{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jeffrey Bishop","gend":0,"currentgend":"","add":"274 WELD RD","city":"PHILLIPS","state":"ME","zip":"04966","dob":"1956-11-17","age":"","mstatus":"","insh":"10000096186","cliId":"","pno":"2076392425","cno":"","email":"kb3qmt@gmail.com","ename":"","eno":"","pphy":"HAMILTON, DEBORAH J","ppno":"2078604090","pcpadd":"Franklin Health Primary Care,131 Franklin Health Commons","pcpcity":"Farmington","pcpstate":"ME","pcpzip":"04938","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"274 WELD RD","madd2":"","madd3":"","mcity":"PHILLIPS","mstate":"ME","mzip":"04966","pcpfaxno":"2078604098","pcpnpi":"1952334864","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1CF7R41DG67","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z4502","Z7901","L03116","I4891","Z0000","D582","R079","R0789","R918","D509","I2510","R531","R5383","D649","K635","F17200","I459","R9431","K3189","K621","K648","K6389","I5022","D62","K2950","D122","D123","K2980","I429","I5020","I071"],"date":["2024-04-30","2023-04-28","2023-04-14","2024-03-29","2024-03-29","2023-08-31","2023-06-02","2023-06-02","2023-06-02","2023-08-09","2023-12-27","2023-08-09","2023-08-09","2023-09-06","2023-08-31","2023-08-31","2023-08-31","2023-08-31","2023-08-31","2023-08-31","2023-08-31","2023-08-31","2023-09-06","2023-09-06","2023-08-31","2023-08-31","2023-08-31","2023-08-31","2023-10-25","2023-11-15","2024-04-10"],"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":[["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Jantoven","","","Select","Select",""],["","","Clindamycin","300 MG","","Select","Select",""],["","","Cefuroxime","500 MG","","Select","Select",""],["","","Fluzone High-Dose","","","Select","Select",""],["","","Spironolactone","25 MG","","Select","Select",""],["","","Omeprazole","40 MG","","Select","Select",""],["","","Atorvastatin","80 MG","","Select","Select",""],["","","Metoprolol Tart","25 MG","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Lisinopril","2.5 MG","","Select","Select",""],["","","Warfarin","2.5 MG","","Select","Select",""],["","","Metoprolol Succ","25 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":""}]}]}