{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Roberta E Power","gend":1,"currentgend":"","add":"46 KITTY LN","city":"BERNARD","state":"ME","zip":"04612","dob":"1957-09-20","age":"","mstatus":"","insh":"10000103423","cliId":"","pno":"2072448369","cno":"","email":"","ename":"","eno":"","pphy":"HANKE, TANYA","ppno":"2072445630","pcpadd":"10 WAYMAN LN,","pcpcity":"BAR HARBOR","pcpstate":"ME","pcpzip":"46091625","pcpcounty":"","pcpid":"","pcpname":"MDI COMMUNITY HEALTH CENTER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"46 KITTY LN","madd2":"","madd3":"","mcity":"BERNARD","mstate":"ME","mzip":"04612","pcpfaxno":"","pcpnpi":"1760644082","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9DX9NA8NM36","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D251","N8003","N840","N812","D259","N8111","N816","N814","N393","G8918","Z48816","N3941","N993","N950","Z90710","R928","Z1231","R519","R300","Z0000","N3281","R32","N3289","F17210","E042","R8290","M25562","M1712","M1711","L400","L578","L821","L408","N3001","S82832A","S82302A","S82852A","S99919S","Z9989","I959","S82842D","S82842A","D649","N8110","E6601","S82892A","S82845D","N3946","N390","N813","J029","H43812","M25561","I10","M25571","L409","Z780","N8501","N83209"],"date":["2023-04-28","2023-04-28","2023-04-28","2023-04-28","2023-04-28","2023-04-28","2023-04-28","2024-05-21","2024-05-21","2023-04-13","2023-05-18","2024-07-26","2023-09-01","2023-09-01","2023-09-01","2024-04-02","2023-09-20","2023-08-28","2023-10-20","2026-02-12","2025-10-31","2025-10-31","2024-01-15","2025-10-31","2024-01-31","2024-04-22","2025-10-19","2024-05-31","2026-02-12","2024-06-21","2024-08-19","2024-06-21","2024-06-21","2024-06-28","2025-10-19","2025-10-19","2025-10-19","2025-10-19","2025-10-19","2025-10-19","2025-11-17","2025-10-19","2023-03-29","2026-03-09","2024-07-08","2025-11-11","2025-11-11","2024-10-21","2025-05-27","2024-07-26","2024-12-11","2024-10-29","2025-06-17","2024-11-21","2024-11-21","2024-08-19","2023-02-10","2023-02-10","2023-01-17"],"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":[["","","HYDROXYZINE HCL","50 MG","","Select","Select",""],["","","OXYCODONE HCL\/ACETAMINOPHEN","5\/325 MG","","Select","Select",""],["","","Clobetasol 0.05 % Ointment Taro","","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Ointment Padagis","","","Select","Select",""],["","","METHYLPREDNISOLONE","4 MG","","Select","Select",""],["","","TRAZODONE","50 MG","","Select","Select",""],["","","SOLIFENACIN","10 MG","","Select","Select",""],["","","SKYRIZI","","","Select","Select",""],["","","LISINOPRIL","40 MG","","Select","Select",""],["","","CITALOPRAM","40 MG","","Select","Select",""],["","","CYCLOBENZAPRINE","10 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","NITROFURANTOIN MACRO\/MONO","100 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","ROSUVASTATIN","5 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Perrigo","","","Select","Select",""],["","","OXYBUTYNIN","15 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","METHOTREXATE","2.5 MG","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","ZOLPIDEM","10 MG","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.001","","Select","Select",""],["","","CLOBETASOL","0.0005","","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":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""],[""]],"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":""}]}]}