{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kathy T Killian","gend":1,"currentgend":"","add":"35 JONESPORT AVE","city":"JONESPORT","state":"ME","zip":"04649","dob":"1955-10-02","age":"","mstatus":"","insh":"10000090717","cliId":"","pno":2075980443,"cno":"","email":"","ename":"","eno":"","pphy":"MOULTON, CHRISTINE C","ppno":2072550102,"pcpadd":"Regional Medical Center at Lubec,893 Main St","pcpcity":"East Machias","pcpstate":"ME","pcpzip":"04630","pcpcounty":"","pcpid":"","pcpname":"REGIONAL MEDICAL CENTER AT LUBEC","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"35 JONESPORT AVE","madd2":"","madd3":"","mcity":"JONESPORT","mstate":"ME","mzip":"04649","pcpfaxno":2077332127,"pcpnpi":1588643886,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2AR4A34PR84","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S42201D","M25511","S42201A","Z1231","S42211A","S4991XA","M170","M25562","M25561","M1711","Z1211","Z887","D120","K6389","S42291G","R7303","K635","F411","Z136"],"date":["2024-04-16","2024-01-19","2024-05-10","2025-01-15","2023-11-30","2024-05-10","2025-06-13","2025-06-13","2024-11-05","2025-08-06","2024-10-03","2023-11-16","2024-10-03","2024-10-03","2023-11-20","2025-06-09","2024-10-03","2024-11-05","2024-11-05"],"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":[["","","OXYCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","TRAZODONE HCL","","","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":""}]}]}