{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Robert L Salisbury","gend":0,"currentgend":"","add":"405 BIGELOW RD","city":"SAINT ALBANS","state":"ME","zip":"04971","dob":"1956-07-11","age":"","mstatus":"","insh":"10000104071","cliId":"","pno":2073997733,"cno":"","email":"Robert.Salisbury@yahoo.com","ename":"","eno":"","pphy":"ALLEN, JAMIEE L","ppno":2076344366,"pcpadd":"RMPC Norridgewock Health Center,87 Mercer Rd","pcpcity":"Norridgewock","pcpstate":"ME","pcpzip":"04957","pcpcounty":"","pcpid":"","pcpname":"RMPC NORRIDGEWOCK HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"405 BIGELOW RD","madd2":"","madd3":"","mcity":"SAINT ALBANS","mstate":"ME","mzip":"04971","pcpfaxno":2076344375,"pcpnpi":1508351560,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7QC5J24HW57","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I4891","I5020","I429","I080","R931","I4819","I428","I480","Z0000","N401","I509","Z23","H9202","Z1211","D123","N529","N486","Z79899","I351","I340","F32A","G4700","J449","M19011","K4090","B079","R5383","J0190","I083","I499","Z7901","R0602","R112","Z0101","I4710","I493","I498","R918","I2510","I10","R6889","I5189","I110","R0689"],"date":["2024-12-11","2025-06-11","2025-05-12","2025-05-12","2025-05-12","2023-06-29","2025-10-27","2025-05-14","2025-09-25","2025-05-13","2025-07-29","2025-11-03","2024-07-12","2025-01-31","2025-01-31","2025-05-13","2025-05-13","2025-05-13","2025-05-12","2025-05-12","2025-02-21","2025-06-13","2025-01-10","2024-12-05","2023-09-29","2023-05-11","2023-09-28","2024-02-15","2024-03-19","2024-03-19","2024-03-19","2024-11-27","2024-12-20","2023-10-12","2025-10-27","2025-10-27","2025-10-27","2024-03-18","2024-03-25","2023-08-30","2023-01-17","2024-04-22","2024-11-06","2023-10-02"],"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":""}]}]}