{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Calvin L Haines","gend":0,"currentgend":"","add":"24 DOUGHTY FARM RD","city":"GRAY","state":"ME","zip":"04039","dob":"1958-05-18","age":"","mstatus":"","insh":"10000106541","cliId":"","pno":"2073835549","cno":"","email":"","ename":"","eno":"","pphy":"BADILLO, JEFFREY","ppno":"2075351200","pcpadd":"Northern Light Mercy Primary Care Yarmouth,385 Rte 1","pcpcity":"Yarmouth","pcpstate":"ME","pcpzip":"04096","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT MERCY PRIMARY CARE YARMOUTH","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"24 DOUGHTY FARM RD","madd2":"","madd3":"","mcity":"GRAY","mstate":"ME","mzip":"04039","pcpfaxno":"2075351249","pcpnpi":"1619538964","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1XK9M05QU52","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E668","R600","N1830","Z6837","H40013","E6601","M25561","I10","G4733","Z0000","D492","D225","L821","D1801","L814","L820","J069","R059","M1712","E782","I129"],"date":["2023-10-30","2023-10-30","2024-06-18","2024-05-08","2023-10-19","2024-06-18","2023-11-08","2024-06-18","2023-12-20","2023-12-28","2023-12-27","2023-12-27","2023-12-27","2023-12-27","2023-12-27","2023-12-27","2024-01-31","2024-02-02","2024-05-08","2024-06-18","2024-06-18"],"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":[["","","Escitalopram","20 MG","","Select","Select",""],["","","Benazepril","40 MG","","Select","Select",""],["","","Pantoprazole","40 MG","","Select","Select",""],["","","Atorvastatin","20 MG","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Amoxicillin\/Clav","875\/125 MG","","Select","Select",""],["","","Topiramate","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":""}]}]}