{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Elizabeth A Darling","gend":1,"currentgend":"","add":"36 COLEBROOK RD","city":"New Gloucester","state":"ME","zip":"04260","dob":"1949-07-17","age":76,"mstatus":"Divorced","insh":"10000043002","cliId":"","pno":2076571548,"cno":"","email":"Badarling1@hotmail.com","ename":"","eno":"","pphy":"KENNEY, BRUCE W","ppno":2077952800,"pcpadd":"76 HIGH ST,","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42407649","pcpcounty":"","pcpid":"","pcpname":"POLAND COMMUNITY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"36 COLEBROOK RD","madd2":"","madd3":"","mcity":"New Gloucester","mstate":"ME","mzip":"04260","pcpfaxno":2077952808,"pcpnpi":1629058185,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1T04PN5FA89","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F418","I10","I7143","K760","Z90710","I7140","J9811","R059","Z95828","J449","J9600","J441","R058","R5381","Z20822","R9431","Z0000","J9611","J439","K7030","E6601","Z6842","E039","Z122","G4733","F17210","Z130","R918","R0602","J8489","J432"],"date":["2024-08-14","2024-08-14","2023-05-05","2023-05-05","2023-05-05","2024-06-05","2023-02-27","2023-02-27","2024-06-05","2024-10-18","2023-02-01","2022-12-06","2022-12-06","2022-12-06","2022-12-06","2023-02-27","2024-11-15","2024-10-18","2023-03-20","2023-03-20","2023-03-20","2023-03-28","2023-03-28","2023-07-25","2023-04-25","2024-06-05","2024-11-08","2022-12-06","2022-12-06","2022-11-01","2022-11-01"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Self-Assessment and Social History (SDOH)","q":[{"a":{"indx":["","","1","",""],"comment":["","","","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"score":[0,0,0,0],"sub":{"indx":[["1","",""],["1","","","","",""],["","","","","","",""],["","","","","","",""],["",""],["",""]],"comment":[["","",""],["","","","","",""],["","","","","","",""],["","","","","","",""],["",""],["",""]],"sub":[]}}},{"a":{"indx":["","","1",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["Member has difficulty walking and doesn't have a car. ",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"arr":["Not applicable"],"comment":[]},{"a":{"indx":["","1",""],"comment":["","",""],"score":[0,0,0,0],"sub":{"indx":[["1","",""],["1","","","",""]],"comment":[["","",""],["","","","",""]],"sub":{"indx":[[],[["","","","1",""]]],"comment":[[],[["","","","",""]]],"sub":[]}}}},{"a":{"indx":["1","",""],"comment":["","",""],"score":[0,0,0,0],"sub":{"indx":[["","1"],["","1"]],"comment":[["",""],["",""]],"sub":{"indx":[[["","","","","1"],["","","","","1"],["","","","","1"]],[]],"comment":[[["","","","",""],["","","","",""],["","","","",""]],[]],"sub":[],"scoreText":"Member informed me she is an alcoholic. "}}}},{"a":[]},{"a":[{"indx":["1",""],"comment":["",""],"sub":[]}]},{"a":{"indx":["","1",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","1",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","1",""],"comment":["","",""],"sub":[]}},{"a":[]},{"a":{"indx":["","","1"],"comment":["","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[["","",""],["","",""],["","",""],["","",""],["","",""],["","",""]]}]},{"t":"Medical History","q":[{"a":{"indx":[],"comment":[],"sub":{"indx":["1","1","","1","","","","","",""],"comment":[""],"sub":{"indx":[[["","","",""],[""]]],"comment":[[["","","",""],[""]]],"sub":[]},"textValue":""}}},{"index":1,"comment":"","sub":[]},{"a":[{"indx":["1","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["1","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["1","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["1","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["1","","","","",""],"comment":["","","","","",""],"sub":[]}]},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["Member had a vein she has to go in and have checked once a year."]],"comment":[[""]],"sub":[]}}},{"a":{"indx":["","","","","","","","","","","","","1"],"comment":["","","","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","1","","","",""],"comment":["","","","","","","",""],"sub":[]}}]},{"t":"Family History","q":[{"index":-1,"comment":"","sub":[]}]},{"t":"Preventive Care","q":[{"a":[[false,""],["",""],["",""],["",""],[true,""],["",""],["",""],["",""],["",""],[true,""],["",""],[true,""],["",""],["",""],{"comment":""}]},{"a":{"indx":["","","1"],"comment":["","",""],"sub":[]}},{"a":{"indx":["1","",""],"comment":["","",""],"sub":[]}}]},{"t":"Allergies \/ Medications","q":[{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"comment":"","sub":[["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","VARENICLINE TARTRATE","","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""]]}},{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[],"textValue":""}}},{"a":[{"indx":["1",""],"comment":["",""],"sub":[]},{"indx":["1",""],"comment":["",""],"sub":[]},{"indx":["1",""],"comment":["",""],"sub":[]},{"indx":["1",""],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]}]},{"a":[]},{"a":[]}]},{"t":"Assessment of Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}],"phq":[{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"subGroup":[{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","","","",""],"comment":["","","","","","",""]},{"indx":["","","","","",false],"comment":[""]}]}]}},{"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":{"indx":["","","1","",""],"comment":["","","","",""],"score":[0,0,0,0],"sub":{"indx":[["1",""],["","1"]],"comment":[["",""],["",""]],"sub":[]}}},{"a":[]},{"a":[""]},{"a":[]},{"a":[]},{"a":{"indx":[false,false,true,false,true],"comment":["","","","",""],"score":["","","","",""]}},{"a":[]},{"a":["None member said she wouldn't work on it"]},{"arr":["I am not interested at this time."],"comment":[]},{"a":{"indx":["","","","","","","1","","","",""],"comment":["","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"2025-09-21T12:10","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"In Person","a10":[],"a11":"","a12":"","a13":"","a15":[],"a14":"","a16":"","a18":"","a19":"true"}]}]}