{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Donna L Smith","gend":1,"currentgend":"","add":"43 THE LANE","city":"NORTH YARMOUTH","state":"ME","zip":"04097","dob":"1949-04-20","age":"","mstatus":"","insh":"10000047022","cliId":"","pno":2078295802,"cno":2078385802,"email":"donnasmith2370@gmail.com","ename":"","eno":"","pphy":"MCELHINNEY, KRISTINA E","ppno":2078469013,"pcpadd":"InterMed,259 Main St","pcpcity":"Yarmouth","pcpstate":"ME","pcpzip":"04096","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"43 THE LANE","madd2":"","madd3":"","mcity":"NORTH YARMOUTH","mstate":"ME","mzip":"04097","pcpfaxno":2078741483,"pcpnpi":1497073746,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1FD7MU2NX59","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0001","E119","I10","E7800","K760","H43811","E1165","N1831","Z713","Z23","G5601","E039","M810","E1122","G5602","G5603","E8352","N1832","Z1231","K7460","Z0000","I129","M11231","M1811","M11232","M1812","M180","M79672","N189","N281","R112","K769","M8588","Z13820","R93421","Z0101","R6889","E162","E8809","L218","E871"],"date":["2024-09-17","2024-04-25","2024-11-18","2024-04-01","2024-05-24","2023-01-05","2024-10-01","2024-10-01","2024-10-01","2024-09-23","2023-07-26","2024-09-17","2024-10-21","2024-04-01","2023-06-08","2023-07-05","2024-11-29","2024-11-18","2024-11-27","2024-04-01","2024-04-01","2024-05-24","2023-07-05","2023-07-05","2023-07-05","2023-07-05","2023-07-05","2024-06-28","2024-11-29","2024-11-29","2022-06-20","2022-06-17","2022-06-15","2022-06-15","2022-05-02","2022-04-19","2022-04-19","2021-10-25","2022-02-02","2022-02-09","2022-02-09"],"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":[["","","JARDIANCE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","FREESTYLE LIBRE 3 SENSOR","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","DESOXIMETASONE","","","Select","Select",""],["","","SYNTHROID","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","FLUAD QUAD 2021-2022","","","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":""}]}]}