{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Chriss H Emery","gend":1,"currentgend":"","add":"147 ALLEN AVE APT 24","city":"PORTLAND","state":"ME","zip":"04103","dob":"1957-05-27","age":"","mstatus":"","insh":"10000097334","cliId":"","pno":"2075361833","cno":"","email":"declined@020926.com","ename":"","eno":"","pphy":"LANG, KRISTEN","ppno":"2078282402","pcpadd":"Martins Point Health Care,331 Veranda St","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04103","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"147 ALLEN AVE APT 24","madd2":"","madd3":"","mcity":"PORTLAND","mstate":"ME","mzip":"04103","pcpfaxno":"2078282433","pcpnpi":"1598298697","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3JN5JR4ME72","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":["M5416","Z98890","M48062","M5450","M5116","G8929","M5442","M5136","M47816","M4316","M5441","I10","Z87891","M48061","E1142","F418","G4730","K219","Z8616","M5126","M5127","M4319","F209","R197","E118","G8918","M549","Z23","R0683","J3489","M4726","G4733","M542","M419","Z130","R079","Z5321","F410","F32A","Z5889","S63681A","M25551","R1030","M160","N390","R262","R4701","M50321","M47812","N3000","G9340","R2689","M79674","M79671","M1611"],"date":["2024-06-17","2023-10-03","2024-01-15","2023-07-23","2023-10-03","2024-06-17","2023-04-02","2024-06-04","2024-06-04","2024-06-04","2023-04-23","2023-07-23","2023-10-03","2023-10-19","2023-05-26","2023-05-26","2023-05-26","2023-09-19","2023-06-07","2023-06-07","2023-06-07","2023-06-07","2023-08-11","2023-09-12","2024-07-02","2023-07-23","2023-07-23","2023-11-16","2023-09-19","2023-09-19","2024-06-17","2024-06-25","2024-04-16","2023-11-07","2023-12-01","2023-11-27","2024-01-13","2024-01-29","2024-01-29","2024-01-29","2024-02-20","2024-06-12","2024-03-03","2024-03-03","2024-04-22","2024-04-22","2024-04-22","2024-04-16","2024-04-16","2024-04-24","2024-04-24","2024-04-23","2024-07-02","2024-06-04","2024-06-12"],"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":[["","","Dexcom G6 Transmitter","","","Select","Select",""],["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Atorvastatin Calcium","","","Select","Select",""],["","","Hydrochlorothiazide","12.5 MG","","Select","Select",""],["","","Metformin","500 MG","","Select","Select",""],["","","Cyclobenzaprine","5 MG","","Select","Select",""],["","","Lisinopril","5 MG","","Select","Select",""],["","","Potassium Cl","20 MEQ","","Select","Select",""],["","","Metoprolol Tart","25 MG","","Select","Select",""],["","","Tramadol","50 MG","","Select","Select",""],["","","Tresiba Flextouch","","","Select","Select",""],["","","Peg 3350\/Electrolytes","420 GM","","Select","Select",""],["","","Gabapentin","600 MG","","Select","Select",""],["","","Dexcom G6 Receiver (Ref Stk-Oe-001)","","","Select","Select",""],["","","Trulicity","","","Select","Select",""],["","","Sertraline","50 MG","","Select","Select",""],["","","Klor-Con M20","","","Select","Select",""],["","","Bupropion Hcl","300 MG","","Select","Select",""],["","","Baclofen","10 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Shingrix","","","Select","Select",""],["","","Dexcom G6 Sensor","","","Select","Select",""],["","","Meloxicam","7.5 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":""}]}]}