{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"John A Vashon","gend":0,"currentgend":"","add":"164 PINES RD","city":"BENTON","state":"ME","zip":"04901","dob":"1946-07-19","age":"","mstatus":"","insh":"10000012346","cliId":"","pno":2074536605,"cno":"","email":"JVASHON2552@GMAIL.COM","ename":"","eno":"","pphy":"WEBB, TIMOTHY S","ppno":2078726869,"pcpadd":"Elmwood Primary Care,221 Main St","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"ELMWOOD PRIMARY CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2074536605,"add2":"","add3":"","madd1":"164 PINES RD","madd2":"","madd3":"","mcity":"BENTON","mstate":"ME","mzip":"04901","pcpfaxno":2078773401,"pcpnpi":1376602276,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3HT9P92PN53","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I6900","S51012A","X58XXXA","M25552","R531","R296","I10","W19XXXA","R69","S299XXA","S3991XA","S3993XA","S0990XA","R0602","R079","R0789","V4940XA","F32A","K5900","R1110","Z4781","I6381","G9389","R410","R0902","R634","R58","R2681","R519","I080","I609","E1122","Z9189","S22019A","F0390","Z789","E119","Z794","Z7984","H5710","K219","F330","S0181XA","S88911A","S066X0A","N189","Z66","I69398","I130","R9089","G319","R4182","S066XAA","S41112A","Z89511","Z743","Z79899","I493","I440","I498","I4949","R739","I152","R001","I499","S066XAD","S32402D","I679","Z8673"],"date":["2025-05-01","2025-05-19","2025-05-19","2025-03-12","2025-02-20","2025-03-24","2025-04-19","2025-04-07","2024-06-06","2025-04-04","2025-04-04","2025-04-04","2025-04-05","2025-04-05","2025-04-06","2024-11-29","2024-11-29","2025-10-16","2025-09-03","2025-03-11","2024-05-09","2025-05-12","2025-05-12","2025-02-20","2025-02-20","2025-06-02","2025-03-27","2025-03-27","2025-04-04","2025-04-07","2025-05-12","2024-10-09","2025-04-07","2025-04-04","2025-06-27","2025-06-27","2025-05-02","2025-05-02","2025-05-02","2025-04-19","2023-02-09","2023-02-09","2025-04-04","2023-02-01","2025-04-04","2025-06-26","2024-04-25","2025-03-01","2024-10-09","2025-04-11","2025-04-11","2025-06-30","2025-04-04","2025-04-28","2025-08-27","2025-04-04","2025-09-03","2025-01-27","2025-01-27","2025-01-27","2025-01-27","2023-10-23","2023-10-23","2025-04-05","2025-04-05","2025-04-09","2025-04-01","2025-06-30","2025-06-30"],"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":[["","","SPIKEVAX 2025-2026 (12Y UP)","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","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":{"indx":[],"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":""}]}]}