{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kenneth C Lawrence","gend":0,"currentgend":"","add":"654 MAIN RD","city":"Holden","state":"ME","zip":"04429","dob":"1963-11-12","age":62,"mstatus":"Single","insh":"10000092983","cliId":"","pno":2079914126,"cno":"","email":"declined@072522.com","ename":"","eno":"","pphy":"PANDEY, SANJAY P","ppno":2079073300,"pcpadd":"St Joseph Internal Medicine,900 Broadway","pcpcity":"Bangor","pcpstate":"ME","pcpzip":"04401","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 95","madd2":"","madd3":"","mcity":"Holden","mstate":"ME","mzip":"04429","pcpfaxno":2079071923,"pcpnpi":1407127475,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8PR0JX5DW30","medicaidid":"","pcpFlag":"","evalName":"Erin Barker, FNP","evalDate":"2025-10-27 12:00 PM","primaryLanguage":"","race":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H9313","M25561","M1230","G8929","J40","Z87891","J471","M1711","I491","R0602","R791","J449","F32A","F17210","R45851","F39","H00011","L0291","G4700","Z0000","D508","G479","E785","R059","R062","D72823","F309","I10","M79604","M79674"],"date":["2024-04-18","2025-09-02","2025-07-15","2025-07-24","2025-04-20","2025-04-20","2025-04-22","2025-09-02","2025-04-21","2025-07-25","2025-04-20","2025-04-20","2022-10-06","2022-10-06","2022-10-07","2024-03-25","2022-10-19","2025-09-04","2025-07-24","2023-09-22","2025-07-31","2024-03-25","2024-03-25","2025-07-24","2025-07-24","2025-07-24","2025-07-24","2024-07-11","2025-06-08","2022-09-12"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","","","","","","","","","","","",""],"comment":["","","","","","","","","","","","",""],"sub":[]}}]},{"t":"Self-Assessment and Social History (SDOH)","q":[{"a":{"indx":["","","","","1"],"comment":["","","","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"score":[0,0,0,0],"sub":{"indx":[["1","",""],["","1","","","",""],["1","1","","","1","",""],["1","","","","","",""],["","1"],["","1"]],"comment":[["","",""],["","","","","",""],["","","","","","",""],["","","","","","",""],["",""],["",""]],"sub":{"indx":[[],[],[],[[{"text":"alone "}]],[[]],[]],"comment":[[],[],[],[[""]],[[]],[]],"sub":[]}}}},{"a":{"indx":["","","1",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"arr":["Retired"],"comment":[]},{"a":{"indx":["1","",""],"comment":["","",""],"score":[0,0,0,0],"sub":{"indx":[["1","","","",""],[""]],"comment":[["","","","",""],[""]],"sub":{"indx":[[["","1","","",""],"I am not interested at this time.",["","","","","","","","","1"]],[]],"comment":[[["","","","",""],[],["","","","","","","","",""]],[]],"sub":[]}}}},{"a":{"indx":["","1",""],"comment":["","",""],"score":[0,0,0,0],"sub":{"indx":[["1",""],["","1"]],"comment":[["",""],["",""]],"sub":[]}}},{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":["","1",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","1",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["1","",""],"comment":["","",""],"sub":{"indx":[["no answer "]],"comment":[[""]],"sub":[]}}},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":{"indx":["","","1"],"comment":["","",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false,false,false,false,false],"comment":["","","","","","","","",""],"score":["","","","","","","","",""]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[["","",""],["","",""],["","",""],["","",""],["","",""],["","",""]]}]},{"t":"Medical History","q":[{"a":{"indx":["1"],"comment":[],"sub":{"indx":[],"comment":[""],"sub":[]}}},{"index":0,"comment":"","sub":[{"sa0":"Rheumatologist","sa1":"","sa2":"Pain "}]},{"a":[{"indx":["","","","","","1"],"comment":["","","","","",""],"sub":[]},{"indx":["","","","1","",""],"comment":["","","","","",""],"sub":{"indx":[["vascularities "],["1","",""]],"comment":[[""],["","",""]],"sub":{"indx":[[],[[]]],"comment":[[],[[]]],"sub":[]}}},{"indx":["","","","","","1"],"comment":["","","","","",""],"sub":{"indx":[["vascularities"]],"comment":[[""]],"sub":[]}},{"indx":["1","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["1","","","","",""],"comment":["","","","","",""],"sub":[]}]},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[[""]],"comment":[[""]],"sub":[]}}},{"a":{"indx":["1","1","1","","","","","","","","1","1",""],"comment":["","","","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","1","","","",""],"comment":["","","","","","","",""],"sub":[]}}]},{"t":"Family History","q":[{"index":-1,"comment":"","sub":[]}]},{"t":"Preventive Care","q":[{"a":[["",""],["",""],[true,""],["",""],[true,""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],{"comment":""}]},{"a":{"indx":["","1",""],"comment":["","",""],"sub":{"indx":[["","",""]],"comment":[["","",""]],"sub":[]}}},{"a":{"indx":["","1",""],"comment":["","",""],"sub":{"indx":[["","",""]],"comment":[["","",""]],"sub":[]}}}]},{"t":"Allergies \/ Medications","q":[{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"comment":"","sub":[["","","FLUCELVAX QUAD 2022-2023","","","Select","Select",""]]}},{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[],"textValue":""}}},{"a":[{"indx":["1",""],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":[false,false,false,false,false,false],"comment":["","","","","",""],"score":["","","","","",""]}},{"a":{"indx":[false],"comment":[""],"score":[""]}}]},{"t":"Assessment of Diagnoses","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false,false,false],"comment":["","","","","","","","",""],"score":["","","","","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false,false],"comment":["","","","","","","",""],"score":["","","","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}],"phq":[{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"subGroup":[{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","","","",""],"comment":["","","","","","",""]},{"indx":["","","","","",false],"comment":[""]}]}]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":[false,false,false,false,false,false],"comment":["","","","","",""],"score":["","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false],"comment":["","","","","","",""],"score":["","","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false],"comment":["","","","","","",""],"score":["","","","","","",""]}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Pain","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]]}}]},{"t":"Vital Signs","q":[{"a":["","","","","","","",false,false,false]},{"a":["","","","",{"txt":""},{"malnutrition":{"indx":["","","","","","",""],"sub":{"indx":[],"comment":[],"sub":[]}}}]},{"a":{"indx":["","","","","","","","","","","",""],"comment":["","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}},{"arr":[],"comment":[]},{"arr":[],"comment":[]},{"a":{"indx":["","","","","","","","",""],"comment":["","","","","","","","",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Exam Review","q":[{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":[""],"comment":[""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"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":{"indx":[false,false,false],"comment":["","",""],"score":["","",""]}}]},{"t":"Mini-Cog","q":[{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":{"data":["","1","","","","0"],"indx":[false,false,false,false,false,false,false,false,false,false,false,false,false,false,false,false,false,false],"version":[false,false,false,false,false,false]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Home Safety & Personal Goals","q":[{"a":{"indx":["","","","",""],"comment":["","","","",""],"score":[0,0,0,0]}},{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":[""]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":{"indx":[false,false,true,true,true],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":["stay away from people "]},{"arr":["I am already working on it but need some help."],"comment":[]},{"a":{"indx":["","1","","","","","","","","",""],"comment":["","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["the marketing people "],[""],[""],[""]],"comment":[[""],[""],[""],[""]],"sub":[]}}}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"This is a complete face-to-face visit performed in the member\u2019s home. Verbal consent was received by the patient to conduct this HRA visit. Patient identity was verified. Counseling on Preventive Health Maintenance recommendations was provided.  Any conditions NOT identified in the HRA are considered resolved or are unable to be confirmed.  The member has been advised to follow up with their PCP or specialist with any questions involving changes, updates, or alteration of their medications and health care. Member advised to contact member services using the number on the back of insurance card with any plan questions or services needed.","a2":"2025-10-27T12:00","a3":"","a4":"","a5":"true","a6":"","a7":[],"a8":"","a9":"In Person","a10":[],"a11":"","a12":"true","a13":"true","a15":[],"a14":"","a16":"","a18":"true","a20":"true","a21":"true"}]}]}