{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Richard C Piper","gend":0,"currentgend":"","add":"11 JIM WARREN RD","city":"Buckfield","state":"ME","zip":"04220","dob":"1944-09-13","age":"","mstatus":"","insh":"10000038819","cliId":"","pno":2074613876,"cno":"","email":"PIPERRANCH@PIPERRANCH.COM","ename":"","eno":"","pphy":"WALL, JEFFREY A","ppno":2077847388,"pcpadd":"190 STETSON RD,","pcpcity":"AUBURN","pcpstate":"ME","pcpzip":"42107813","pcpcounty":"","pcpid":"","pcpname":"FAMILY HEALTH CARE ASSOCIATES","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"11 JIM WARREN RD","madd2":"","madd3":"","mcity":"Buckfield","mstate":"ME","mzip":"04220","pcpfaxno":2077952043,"pcpnpi":1447288808,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8T47AW7CD55","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M722","M216X1","M79671","R600","M21379","G4700","Z0000","I4891","I509","I10","S32441A","Z98890","J90","I5020","I517","I700","M109","N179","L247","M9701XD","I5023","I110","E669","D3502","H903","Z96649","S72111A","J95821","R571","R579","T8110XA","M9701XA","M978XXA","I499","T849XXA","W000XXA","Z96651","Z96641","H348310","Z09","K219","R7401","M25551","M25561","W1849XA","E785","N401","S7290XA","N281","N400","M79661","I739","G629","Z79899","H40013","M25559","M21371","R4589","S72301A","S79911A","S8991XA","Z0101","H25813","Z0389","J9811","Z4682","Z471","I429","L570","L821","L814","M9903","M47818","M9905","M62830"],"date":["2023-03-20","2023-03-20","2025-03-04","2025-06-06","2025-06-06","2024-03-29","2025-11-07","2025-11-07","2025-11-07","2025-11-07","2024-02-09","2024-07-10","2024-09-28","2024-11-19","2024-11-19","2024-11-19","2023-04-11","2024-02-16","2023-07-08","2024-04-14","2024-09-30","2025-03-04","2024-09-30","2025-03-04","2023-03-10","2024-10-25","2024-02-09","2024-02-09","2024-02-09","2024-02-09","2024-02-20","2024-02-15","2024-02-15","2024-02-08","2024-02-09","2024-02-07","2024-02-07","2024-02-09","2025-05-09","2024-10-22","2024-09-28","2024-09-28","2024-02-07","2024-02-07","2024-02-07","2023-01-05","2023-01-05","2024-10-25","2024-02-28","2024-02-28","2025-03-04","2025-03-04","2025-03-04","2025-06-06","2024-11-06","2024-02-22","2024-07-22","2024-11-22","2024-02-07","2024-02-07","2024-02-07","2024-10-28","2024-10-28","2024-02-09","2024-02-11","2024-02-12","2024-02-09","2025-04-10","2022-09-28","2022-09-28","2022-09-28","2022-09-12","2022-09-12","2022-09-12","2022-09-12"],"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":""}]}]}