{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Craig L Sites","gend":0,"currentgend":"","add":"141 HINCKLEY HILL RD","city":"CARMEL","state":"ME","zip":"04419","dob":"1955-10-01","age":"","mstatus":"","insh":"10000097042","cliId":"","pno":"2078483048","cno":"","email":"sitesauto@gmail.com","ename":"","eno":"","pphy":"BAXTER, RAYMOND J","ppno":"","pcpadd":"EMMC Family Medicine Center and Residency,895 Union St Ste 12","pcpcity":"Bangor","pcpstate":"ME","pcpzip":"04401","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT FAMILY MEDICINE AND RESIDENCY","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"141 HINCKLEY HILL RD","madd2":"","madd3":"","mcity":"CARMEL","mstate":"ME","mzip":"04419","pcpfaxno":"2079735042","pcpnpi":"1427491240","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1PX5T07WN87","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R42","M9901","M542","M9903","M9904","H9319","E781","Z0000","L600","G5701","L03032","M7918","Z791","Z79899","Z09","H5203","H52223","H524","Z0101","M62838","M9902"],"date":["2023-05-16","2024-06-13","2024-06-13","2023-05-23","2023-05-23","2023-05-16","2023-07-03","2024-04-17","2023-08-21","2023-10-02","2023-09-19","2023-10-02","2023-09-14","2023-09-14","2023-10-06","2024-01-04","2024-01-04","2024-01-04","2024-01-04","2024-06-13","2024-06-13"],"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":[["","","Atenolol","50 MG","","Select","Select",""],["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Lorazepam","1 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Atorvastatin","40 MG","","Select","Select",""],["","","Oxycodone Hcl\/Acetaminophen","5\/325 MG","","Select","Select",""],["","","Rosuvastatin","40 MG","","Select","Select",""],["","","Meclizine","25 MG","","Select","Select",""],["","","Cyclobenzaprine","5 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":""}]}]}