{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Genevieve L Steward","gend":1,"currentgend":"","add":"1480 BRANCH RD","city":"WELLS","state":"ME","zip":"04090","dob":"1934-06-20","age":"","mstatus":"","insh":"10000038181","cliId":"","pno":2079853344,"cno":"","email":"genielou34@gmail.com","ename":"","eno":"","pphy":"Mckeon, Kathleen A","ppno":"","pcpadd":"40 PARK RD,","pcpcity":"WESTBROOK","pcpstate":"ME","pcpzip":"40923188","pcpcounty":"","pcpid":"","pcpname":"FAMILY PRACTICE ON THE RIVER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1480 BRANCH RD","madd2":"","madd3":"","mcity":"WELLS","mstate":"ME","mzip":"04090","pcpfaxno":"","pcpnpi":1649427329,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3NW0VF2TE00","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M9901","M531","K641","E039","M1611","S0990XA","H6123","J020","R030","R600","I10","M797","M4726","F411","Z7189","E678","L03116","Z7689","S199XXA","M48062","L570","D492","L299","L942","R202","L2489","K625","F410","H6122","F4320","M542","M7910","K594","E669","K649","M48061","M5127","M47817","M4316","Z01818","Z01810","L84","R300","R609","I440","M160","L290","K642","R5383","Z0001","T1490XA","L03114","G8929","M5441","M1711","M51360","M47816","M5416","Z471","Z96641","S91341S","M25552","M25551","M069","R531","K644","T1490XD","L708","D485","B351","M79674","M79675","L852","M79671","M79672","J45909","R4182","G479"],"date":["2022-10-26","2022-10-26","2025-02-05","2025-06-02","2025-06-02","2024-11-02","2024-01-26","2023-12-20","2023-09-09","2025-05-12","2025-06-04","2024-09-09","2024-11-25","2024-11-25","2024-11-25","2023-10-12","2025-05-12","2025-05-12","2024-11-02","2025-03-25","2024-08-15","2023-08-10","2025-05-12","2024-01-25","2024-11-02","2024-09-25","2025-02-05","2025-05-03","2025-03-21","2024-05-09","2022-08-08","2022-08-08","2025-02-05","2022-10-13","2022-10-13","2025-01-10","2025-01-10","2025-01-10","2025-03-25","2025-05-13","2025-03-06","2022-08-23","2022-08-23","2022-08-23","2025-03-06","2025-01-08","2024-03-06","2023-07-26","2022-08-11","2023-05-23","2023-05-23","2023-05-23","2023-05-23","2024-10-10","2024-12-04","2025-03-25","2025-03-25","2025-01-10","2025-06-02","2025-06-02","2024-08-07","2025-01-28","2025-02-19","2023-04-18","2024-11-05","2024-09-25","2023-06-22","2023-02-09","2023-02-09","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2025-06-02","2025-06-02","2022-06-30"],"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":[["","","MELOXICAM","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","ARMOUR THYROID","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","NP THYROID","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","NYSTATIN","","","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":""}]}]}