{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Pamela P Morris","gend":1,"currentgend":"","add":"1520 PARSONS RD","city":"WASHBURN","state":"ME","zip":"04786","dob":"1957-06-24","age":"","mstatus":"","insh":"10000096203","cliId":"","pno":2074354221,"cno":"","email":"rhubarbland@gmail.com","ename":"","eno":"","pphy":"DASHTI, BEHNOOSH","ppno":2077696636,"pcpadd":"140 ACADEMY ST,","pcpcity":"PRESQUE ISLE","pcpstate":"ME","pcpzip":"47693102","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT WOMENS HEALTH","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1520 PARSONS RD","madd2":"","madd3":"","mcity":"WASHBURN","mstate":"ME","mzip":"04786","pcpfaxno":"","pcpnpi":1326751223,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8MC6JJ4EM89","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R6889","H35371","Z0101","Z48817","Z1151","Z01419","H442B2","H26492","G43B0","L986","J329","S1095XA","Z131","Z0000","G5603","L821","D1801","Z85820","Z124","Z48810","L309","M4802","M5136","G8929","M1711","M47812","M47816","H5213","H25812","I059","Z791","Z881","H25813","Z0001","H40052","H5231","Z01818","M25561","M25461","M5450"],"date":["2022-11-07","2024-12-31","2025-05-05","2023-02-17","2025-01-28","2025-01-28","2023-07-12","2023-07-12","2023-07-12","2023-02-03","2023-05-16","2023-05-16","2025-03-26","2025-01-28","2023-07-21","2023-02-03","2023-02-03","2023-02-03","2025-01-28","2022-10-27","2024-12-03","2023-09-26","2023-09-26","2023-06-20","2023-06-20","2023-06-20","2023-06-20","2022-11-07","2022-09-27","2022-09-27","2022-09-27","2022-09-27","2022-08-25","2022-08-30","2022-08-25","2022-08-25","2022-09-07","2022-08-30","2022-08-30","2022-08-30"],"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":[["","","BETAMETHASONE DIPROPIONATE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","MOXIFLOXACIN","","","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":{"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":""}]}]}