{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Cynthia M Kuhns","gend":1,"currentgend":"","add":"35 DESERT POND RD","city":"MOUNT VERNON","state":"ME","zip":"04352","dob":"1956-10-19","age":"","mstatus":"","insh":"10000089574","cliId":"","pno":2072932194,"cno":"","email":"","ename":"","eno":"","pphy":"CRAWFORD, KARA M","ppno":2076218800,"pcpadd":"Augusta Family Medicine,15 Enterprise Dr","pcpcity":"Augusta","pcpstate":"ME","pcpzip":"04330","pcpcounty":"","pcpid":"","pcpname":"AUGUSTA FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"35 DESERT POND RD","madd2":"","madd3":"","mcity":"MOUNT VERNON","mstate":"ME","mzip":"04352","pcpfaxno":2076218801,"pcpnpi":1578654505,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4WP6AR2YX48","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M1611","M170","Z96642","M21371","C50919","R634","E785","Z0100","C50212","M8580","M2550","Z170","Z1231","Z96651","Z4889","M25551","Z853","Z01810","R9431","I10","Z79899","M5126","M5136","M48061","M5137","M4187","M25562","S83011A","M25561","Z471","Z96641","M1712","I219","Z981","Z0000","H9190","M4316","Z01812","Z79811","Z96643","H903","C50912","Z23","M8589","M8588"],"date":["2023-08-08","2023-05-16","2023-08-25","2023-05-16","2025-11-06","2025-11-06","2024-11-21","2024-11-05","2025-11-03","2023-06-13","2022-12-13","2024-06-06","2024-12-30","2024-03-12","2024-03-12","2023-08-09","2023-07-17","2023-06-26","2023-06-26","2023-06-26","2023-06-26","2023-09-30","2023-09-30","2023-09-30","2023-09-30","2022-12-20","2022-12-20","2022-12-20","2022-12-20","2023-08-08","2023-08-09","2023-09-26","2023-06-08","2022-12-20","2023-08-25","2023-08-25","2023-08-25","2023-06-08","2024-06-06","2023-08-07","2023-10-09","2023-11-28","2022-10-07","2022-08-22","2022-08-22"],"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":[["","","SIMVASTATIN","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","PAROXETINE HCL","","","Select","Select",""],["","","LETROZOLE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","FLUCELVAX TRIVALENT 2024-2025","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","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":""}]}]}