{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Cindy M Tufts","gend":1,"currentgend":"","add":"114 PROSPECT ST APT 48","city":"Biddeford","state":"ME","zip":"04005","dob":"1960-09-14","age":"","mstatus":"","insh":"10000086518","cliId":"","pno":2072863943,"cno":"","email":"declien@nomail.com","ename":"","eno":"","pphy":"MOREAU, SHANNON N","ppno":2072831441,"pcpadd":"Martins Point Health Care,61 Barra Rd","pcpcity":"Biddeford","pcpstate":"ME","pcpzip":"04005","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"114 PROSPECT ST APT 48","madd2":"","madd3":"","mcity":"Biddeford","mstate":"ME","mzip":"04005","pcpfaxno":2075231136,"pcpnpi":1629337902,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6R88XD2AH43","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L821","I10","G4733","E66813","Z6843","M1611","L820","R42","E876","J40","H16042","Z131","G379","K219","R7303","Z23","I5033","Z1231","M5416","E6601","R531","M2550","M65331","R110","R519","I959","I509","M1612","R7989","R300","I340","I517","J0100","Z713","M25552","D8989","G250","G5603","Z20822","M159","M797","R5383","E559","M25561","M25461","Z0100","J0190","R059","Z0001","Z7189","M5117","M25551","R0602","R269","E785","I110"],"date":["2024-02-19","2025-01-22","2025-10-21","2025-10-21","2025-10-21","2025-10-21","2024-02-19","2024-10-28","2024-07-22","2023-12-26","2025-04-25","2024-07-22","2025-07-16","2025-07-16","2025-07-16","2024-10-17","2025-05-13","2025-11-14","2025-05-23","2025-05-23","2023-05-13","2024-10-18","2024-02-14","2023-05-11","2023-05-11","2023-05-11","2024-03-12","2023-08-02","2025-01-03","2025-01-06","2024-03-12","2024-03-12","2024-09-24","2025-09-09","2023-08-02","2023-09-11","2023-09-11","2023-09-11","2023-04-24","2025-01-23","2025-01-22","2023-08-02","2023-07-25","2025-01-28","2025-01-28","2025-03-05","2025-01-14","2025-01-14","2023-07-25","2023-07-25","2024-10-18","2024-10-18","2023-04-24","2022-09-28","2022-08-10","2022-08-10"],"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":""}]}]}