{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Nancy SUE Kennedy","gend":1,"currentgend":"","add":"60 BAGATELLE LN","city":"BRUNSWICK","state":"ME","zip":"04011","dob":"1935-07-12","age":"","mstatus":"","insh":"00008230100","cliId":"","pno":2073730578,"cno":2077982581,"email":"skennedy.me@gmail.com","ename":"","eno":"","pphy":"Not A Valid Pcp","ppno":"","pcpadd":"331 VERANDA ST,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"04103","pcpcounty":"","pcpid":"","pcpname":"","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"60 BAGATELLE LN","madd2":"","madd3":"","mcity":"BRUNSWICK","mstate":"ME","mzip":"04011","pcpfaxno":"","pcpnpi":1234567893,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1PA0TN0AN19","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z4789","M25561","H903","M6281","M47816","R152","N393","I10","R262","R531","S72401S","S72491D","T8484XA","F5101","S72401D","R634","D801","M5416","M533","R918","M1711","G8918","I110","I5032","M21061","M1731","S8991XD","S8001XA","W19XXXA","G5601","G5602","M8580","I50812","R5383","E538","R0600","M5450","S01111D","G4700","F321","R52","G5603","A000","T8484XD","R9389","S72421A","F1020","Z471","Z96651","D62","M25511","W19XXXD","J410","R0609","M810","E782","S72491A","W010XXD","R29898","E669","M25551","M160","S72401A","M2540","S72351A","M25461","M85861","Z0389","Z20822","E559","S8991XA","M79651","M79606","D485","R159","S72001A","R102","R4182","U071","M5135","M51360","M4316","M25519","S4991XA","X500XXA","Z1231","M25552","F331","I4711","I2510","I517","I358","I700","L821","Z85828","D229","L570","R0602","E8352","N178","Z23","N6320","K7689","E041","Z472","I3481","M48061","S2241XA","Y831","Z98890","M47817","S0101XA"],"date":["2024-07-08","2024-07-08","2024-06-21","2023-10-24","2025-04-17","2022-07-28","2022-07-28","2024-02-05","2023-07-14","2025-05-05","2023-07-14","2023-04-06","2023-11-02","2023-03-21","2023-05-31","2023-11-02","2024-11-25","2025-06-24","2025-06-24","2024-07-05","2024-02-05","2024-02-05","2024-02-02","2024-02-02","2024-02-02","2023-06-30","2023-02-08","2023-01-23","2023-11-14","2025-01-07","2025-05-08","2024-07-25","2024-02-22","2024-02-22","2024-07-24","2023-02-07","2025-05-07","2024-07-29","2024-02-02","2025-04-16","2023-06-30","2024-12-18","2024-02-05","2023-12-14","2023-07-13","2023-02-19","2023-02-21","2024-03-20","2024-03-20","2023-02-28","2023-12-04","2023-03-08","2023-07-13","2023-07-13","2023-12-05","2023-12-05","2023-03-06","2023-03-06","2024-04-15","2023-03-01","2023-02-18","2025-02-26","2023-02-19","2023-02-19","2023-02-18","2023-02-18","2023-02-18","2024-04-15","2023-02-21","2024-09-26","2023-01-18","2023-02-18","2023-02-18","2024-03-28","2023-02-18","2023-02-18","2023-02-18","2023-02-19","2023-02-23","2025-04-17","2025-04-17","2025-04-17","2023-11-12","2023-11-14","2023-11-12","2024-08-07","2025-02-26","2025-03-13","2024-10-21","2024-07-05","2023-08-15","2023-08-15","2023-08-15","2023-11-16","2023-11-16","2023-11-16","2022-11-10","2023-08-15","2024-11-05","2024-11-05","2024-10-03","2023-06-15","2024-07-05","2024-07-05","2023-11-02","2023-07-21","2025-05-19","2025-06-13","2023-11-02","2023-11-02","2025-05-01","2022-06-16"],"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":[]},{"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":""}]}]}