{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lyla A Carlow","gend":1,"currentgend":"","add":"263 BRICKETT POINT ESTATE","city":"OAKLAND","state":"ME","zip":"04963","dob":"1957-11-24","age":"","mstatus":"","insh":"10000100388","cliId":"","pno":2076602218,"cno":"","email":"laylacarlow@gmail.com","ename":"","eno":"","pphy":"KEISKI, LISA K","ppno":"","pcpadd":"Waterville Family Practice,31 Front St","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"WATERVILLE FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"263 BRICKETT POINT ESTATE","madd2":"","madd3":"","mcity":"OAKLAND","mstate":"ME","mzip":"04963","pcpfaxno":2074420407,"pcpnpi":1558349662,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1VV6N07MD57","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["T8131XD","Y838","Z90710","F17200","Z01811","R942","S060X1A","R1900","Z1231","K632","R911","C3411","R55","C3490","T8183XA","Z510","T8130XA","F17210","K122","Z85118","Z98890","J432","S31109D","T8130XD","R918","R0600","K5730","K760","S31109A","J449","T8131XA","R079","K432","E11621","Z716","R509","L929","R6889","J439","Z79899","H5203","H524","H52223","C3412","Z0101","H2513","Y839","E785","I10","K5750","I8391","S0990XA","Z01818","K567","T8132XA","F1010","N949","L988","R739","T8189XD","Z87891","Z4889","Z853","I2510","K219","W1830XA","Z0000","T148XXA","S060XAA","M85851","M85852","R062","Z122","R9389","N83202"],"date":["2024-06-26","2023-10-09","2024-06-26","2025-01-16","2025-07-29","2024-05-22","2024-01-22","2023-01-27","2024-10-14","2024-09-16","2025-08-15","2025-08-28","2024-02-02","2025-05-29","2024-08-29","2025-03-07","2024-06-14","2025-11-06","2024-09-28","2025-08-15","2025-08-15","2023-05-15","2023-10-09","2023-05-22","2025-10-17","2024-08-13","2023-11-27","2023-11-27","2024-06-26","2024-08-13","2024-06-25","2024-01-22","2025-11-06","2023-10-23","2023-04-05","2023-02-04","2023-10-23","2023-12-05","2025-08-15","2024-02-02","2024-12-12","2024-12-12","2024-12-12","2025-06-02","2024-12-12","2024-12-12","2023-09-25","2025-05-29","2025-05-29","2024-06-10","2023-09-21","2024-01-22","2022-12-30","2023-01-27","2023-01-27","2023-09-11","2022-12-30","2023-09-21","2023-09-21","2024-06-10","2024-05-20","2024-09-13","2025-03-11","2025-08-15","2024-01-22","2024-02-02","2024-03-01","2024-06-18","2024-02-02","2024-03-11","2024-03-11","2024-08-13","2024-05-20","2022-11-08","2022-11-22"],"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":[]},{"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":""}]}]}