{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jeannette Parent","gend":1,"currentgend":"","add":"271 ALDER ST","city":"MADAWASKA","state":"ME","zip":"04756","dob":"1948-05-06","age":"","mstatus":"","insh":"10000025581","cliId":"","pno":2077283837,"cno":"","email":"","ename":"","eno":"","pphy":"MCGLAUGHLIN, DEBBRA A","ppno":2078346140,"pcpadd":"460 MAIN ST,SUITE 201","pcpcity":"MADAWASKA","pcpstate":"ME","pcpzip":"47561014","pcpcounty":"","pcpid":"","pcpname":"ACADIA FAMILY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"271 ALDER ST","madd2":"","madd3":"","mcity":"MADAWASKA","mstate":"ME","mzip":"04756","pcpfaxno":2077287838,"pcpnpi":1922030527,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9CY6V05VR41","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M19011","Z471","M19012","S3210XA","I10","L0390","Z98890","M542","M5412","R0902","J449","R634","J439","Z7951","Z79899","Z7952","M25519","Z96612","M25511","M9901","M24611","E871","E7800","M75101","Z96619","Z23","M9903","M5450","G5712","J441","Z09","Z5181","F411","M24511","M12811","Z1211","Z87891","M25512","Z87828","J9691","E559","Z01812","G8918","M5416","Z01818","S41111A","R790","Z1231","Z0000","R0602","S329XXA","M2550","G4734","M19019","E785","M19212","M533","Z780","N951","M24612","M9902","M546","E039","R52","M958","Z96611","M24541","M24542","M720","Z789","R4182","J9621","F449","S3210XD","R799","M79641","U071","R0600","Z0100","M75102","M549","M25531","M75121","M75122"],"date":["2024-10-22","2024-01-09","2023-12-21","2025-05-05","2025-03-27","2024-04-19","2024-02-01","2024-05-30","2025-03-27","2025-04-13","2025-08-08","2025-01-13","2025-09-05","2024-03-05","2024-03-05","2025-06-10","2024-12-31","2024-06-07","2025-02-19","2023-05-03","2025-01-21","2025-06-17","2025-03-13","2024-01-05","2024-05-03","2024-10-15","2023-03-29","2023-03-22","2023-03-22","2025-09-08","2024-02-02","2024-10-02","2025-07-09","2024-01-05","2024-01-05","2023-03-23","2025-06-10","2025-02-19","2023-07-14","2025-01-02","2025-05-23","2025-01-07","2024-09-19","2023-03-06","2023-12-26","2023-09-28","2025-05-30","2023-11-03","2024-09-16","2025-05-25","2025-04-28","2024-06-18","2023-12-06","2023-05-08","2023-12-26","2023-04-18","2025-04-08","2023-09-11","2023-09-11","2025-01-21","2022-10-24","2022-10-12","2024-03-29","2024-12-06","2025-01-21","2025-01-21","2025-07-01","2025-07-01","2025-06-17","2025-05-15","2025-05-01","2024-12-06","2025-05-01","2025-06-04","2025-07-07","2025-06-06","2024-02-26","2023-05-12","2025-05-13","2023-06-14","2025-04-08","2025-06-06","2022-09-20","2022-09-20"],"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":[["","","OHTUVAYRE","","","Select","Select",""],["","","ALBUTEROL SULFATE","","","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":""}]}]}