{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda L Kay","gend":1,"currentgend":"","add":"106 FISCHER RD","city":"MONROE","state":"ME","zip":"04951","dob":"1954-12-06","age":"","mstatus":"","insh":"10000075119","cliId":"","pno":2072146695,"cno":"","email":"LRAYNER1@AOL.COM","ename":"","eno":"","pphy":"MAMULA, MEGHAN R","ppno":2079891567,"pcpadd":"Brewer Medical Center,735 Wilson St","pcpcity":"Brewer","pcpstate":"ME","pcpzip":"04412","pcpcounty":"","pcpid":"","pcpname":"BREWER MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"106 FISCHER RD","madd2":"","madd3":"","mcity":"MONROE","mstate":"ME","mzip":"04951","pcpfaxno":2079470435,"pcpnpi":1457456733,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8VE5Q47MT56","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z1211","Z1212","M9901","M542","M9902","M546","S7012XA","R7301","S61412A","W540XXA","Y9329","M170","H2512","H2511","Z1231","R079","M25461","S59912A","S59902A","S3992XA","S79912A","G4733","G4736","E039","E669","M9903","M62838","L723","K760","Z0100","M1712","Z6841","S3993XA","S3991XA","R1084","R102","R600","L720","M19012","R0781","E559","R739","I77819","S7002XA","Z8249","I700","R011","S60221A","R109","Z780","M25512","H35363","R3915","L820","L538","R208","Z789","D1801","L814","L821","Z7189","N200","N201","M79641","Z8669","E785","L0231","Z0000","M5459","R058","Z03818","J069","M9907","M5450","M6289"],"date":["2025-06-15","2025-06-15","2023-01-04","2025-09-02","2023-01-04","2023-01-04","2025-07-09","2023-03-29","2025-01-07","2024-12-29","2024-12-29","2025-07-23","2024-04-01","2024-04-15","2025-07-24","2023-09-13","2025-07-07","2025-07-09","2025-07-09","2025-07-09","2025-07-09","2025-06-16","2025-06-16","2025-04-22","2025-07-23","2022-12-14","2022-12-14","2025-09-16","2023-07-03","2025-04-11","2025-07-07","2024-02-09","2025-07-09","2025-07-09","2025-07-09","2025-07-09","2024-05-03","2025-08-12","2025-10-28","2025-10-28","2024-04-19","2025-04-22","2025-06-18","2025-07-22","2023-09-13","2025-06-18","2025-06-18","2025-03-13","2024-10-02","2023-05-24","2025-10-28","2025-04-11","2025-10-28","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2024-10-04","2024-10-02","2025-03-13","2025-06-12","2025-04-22","2025-07-09","2023-05-24","2025-07-22","2022-11-12","2022-11-12","2022-11-12","2022-08-24","2022-09-08","2022-07-27"],"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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}