{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linnea L Koons","gend":1,"currentgend":"","add":"9 SADIE DUNN RD","city":"READFIELD","state":"ME","zip":"04355","dob":"1957-01-27","age":"","mstatus":"","insh":"10000094428","cliId":"","pno":2073205537,"cno":"","email":"LLKOONS@OUTLOOK.COM","ename":"","eno":"","pphy":"CATHCART, SCOTT","ppno":2077745816,"pcpadd":"Intermed,84 Marginal Way Ste 700","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04101","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"9 SADIE DUNN RD","madd2":"","madd3":"","mcity":"READFIELD","mstate":"ME","mzip":"04355","pcpfaxno":"","pcpnpi":1659876571,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3W88M25EC50","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0000","Z23","Z1231","M8588","M1711","M25561","M25552","C44319","S83281A","W5519XA","M85852","S83411A","S83241A","G8921","Z0184","D649","D225","L821","D1801","L814","D492","C44329","L570","Z808","Z0101","R6889","S83231A","R011","H04123","H2513","Z0100","Z13220","S83271A","Z9189","R509","J0190","M7910","Z03818","H9221","Z0001"],"date":["2025-03-17","2025-03-31","2024-10-15","2023-08-03","2025-06-25","2025-06-25","2023-01-17","2025-03-13","2024-05-22","2024-05-22","2025-03-20","2025-06-16","2025-06-16","2024-01-09","2025-03-20","2022-12-14","2023-12-05","2024-12-10","2024-12-10","2024-12-10","2024-12-10","2024-04-11","2024-12-10","2022-12-13","2025-08-14","2023-11-02","2024-07-10","2025-06-18","2024-07-09","2024-07-09","2024-07-09","2025-03-20","2024-07-10","2023-09-07","2022-10-12","2022-10-08","2022-10-08","2022-04-24","2022-04-24","2022-03-03"],"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":[["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","NAPROXEN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","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":""}]}]}