{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jeffrey R Morris","gend":0,"currentgend":"","add":"636 WEBBS MILLS RD","city":"RAYMOND","state":"ME","zip":"04071","dob":"1957-03-29","age":"","mstatus":"","insh":"10000105772","cliId":"","pno":"2076274790","cno":"","email":"jtmorris001@outlook.com","ename":"","eno":"","pphy":"FAY SHIELDS, JACOB A","ppno":"2078392559","pcpadd":"Martins Point Health Care,575 Main St","pcpcity":"Gorham","pcpstate":"ME","pcpzip":"04038","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"636 WEBBS MILLS RD","madd2":"","madd3":"","mcity":"RAYMOND","mstate":"ME","mzip":"04071","pcpfaxno":"2075231135","pcpnpi":"1467038042","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2KC5A61MU84","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":["Z950","I10","Z45018","G629","K900","D472","M25552","M7072","R490","H903","K219","R1310","K2980","R12","J9811","R918","Z23","I480","R0789","G609","R6882","Z125","Z0100","K429","M25512","S43422D","T148XXA","E782"],"date":["2024-07-11","2023-12-29","2024-01-11","2023-07-19","2023-09-29","2023-12-29","2023-10-19","2023-10-19","2023-09-05","2023-09-05","2023-10-04","2023-10-04","2023-10-04","2023-10-04","2023-10-16","2023-10-16","2023-11-02","2023-12-21","2023-12-21","2024-01-04","2024-01-04","2024-01-04","2024-02-05","2024-02-14","2024-04-16","2024-07-11","2024-03-27","2024-07-05"],"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":[["","","Prednisone","20 MG","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Lupin","","","Select","Select",""],["","","Atorvastatin","20 MG","","Select","Select",""],["","","Verapamil","240 MG","","Select","Select",""],["","","Quinapril Hcl","","","Select","Select",""],["","","Fluzone High-Dose","","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Enalapril","10 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":""}]}]}