{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Alice W Duston","gend":1,"currentgend":"","add":"67 MAIN ST","city":"Cherryfield","state":"ME","zip":"04622","dob":"1944-02-24","age":"","mstatus":"","insh":"10000085907","cliId":"","pno":2074607559,"cno":"","email":"aliceduston1944@gmail.com","ename":"","eno":"","pphy":"HATHEWAY, JOSEPH H","ppno":"","pcpadd":"Anchored Womens Health,710 Bucksport Rd","pcpcity":"Ellsworth","pcpstate":"ME","pcpzip":"04605","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE BLUE HILL","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 36","madd2":"","madd3":"","mcity":"Cherryfield","mstate":"ME","mzip":"04622","pcpfaxno":7078249335,"pcpnpi":1386296242,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2A45V02RE76","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G4733","K760","H0016","K0889","I6523","R7989","D72829","I10","N136","N2889","R222","Z1231","N200","S46012A","C9110","R0683","F331","M25561","E669","D72820","C679","E6601","Z6841","L578","L821","G548","D229","Z8551","Z87891","B3731","L989","Z7689","M75122","Z9049","Z124","N132","R059","G4736","D7589","B3732","N952","B358","H2513","H04123","H01022","H01025","Z0000","S4992XA","R1031","R6889","R748","R109","N23","N390","N12","M6281","N3946","N1330","E279","L570","I70201","Z08","J8489","M19012","R69","E869","M25512","A4151","R7881","A419","E785","R062","M25511"],"date":["2025-09-05","2025-05-30","2024-07-23","2024-09-01","2025-05-12","2024-12-13","2025-03-31","2025-04-08","2023-02-21","2023-03-14","2023-04-27","2023-10-31","2023-03-15","2022-11-18","2025-05-30","2023-05-21","2023-10-31","2025-04-24","2025-04-08","2025-06-26","2024-04-10","2024-09-16","2023-02-28","2025-01-27","2025-01-27","2025-01-27","2025-01-27","2025-05-22","2025-05-22","2025-05-15","2025-06-24","2022-10-28","2022-10-26","2024-02-02","2023-11-13","2023-02-21","2023-05-21","2023-05-21","2025-05-22","2023-11-13","2023-11-13","2023-11-13","2025-05-12","2025-05-12","2025-05-12","2025-05-12","2023-05-02","2022-11-18","2023-02-20","2023-01-19","2024-03-11","2023-02-21","2023-02-20","2023-03-15","2023-02-21","2025-07-08","2025-07-08","2023-02-21","2023-04-27","2024-01-15","2025-05-12","2025-04-02","2025-05-30","2022-11-18","2022-09-13","2022-08-25","2022-09-08","2022-09-02","2022-08-27","2022-08-27","2022-09-02","2022-07-01","2022-07-06"],"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":""}]}]}