{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Stephanie J Cheevers","gend":1,"currentgend":"","add":"478 BELGRADE RD","city":"OAKLAND","state":"ME","zip":"04963","dob":"1956-06-23","age":"","mstatus":"","insh":"10000108312","cliId":"","pno":2073144767,"cno":"","email":"stjojo23@yahoo.com","ename":"","eno":"","pphy":"PHELPS, JULIE J","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":"478 BELGRADE RD","madd2":"","madd3":"","mcity":"OAKLAND","mstate":"ME","mzip":"04963","pcpfaxno":2078731186,"pcpnpi":1679562979,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2P45DG5WR96","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R059","M47816","M4187","M4316","M549","D492","L578","L814","Z1231","R92323","L718","S52502A","G8918","M25532","Z0000","Z1331","Z1389","Z139","H40023","H40053","R030","R42","R519","H539","D3131","H25093","M25571","M65341","M1712","Z0100","S6992XD","E782","M65331","L918","S52572A","M170","S62102S","M85859","G8929","S52502D","S60912A","Z743","D225","L821","L568","M25572","S52602A","W1830XA","Y92512","S86311S","W19XXXS","M7731","M7661","Z23","R7301","M7989","M25522","R6889","M66861","Z13820","Z4789","S62102D","S52352A","S52612A","M25551","I10","S52572D","X58XXXD","M67472","X509XXA","Y93F2","S86819D"],"date":["2024-04-27","2023-12-11","2023-12-11","2023-12-11","2024-08-08","2023-10-26","2023-10-26","2024-10-24","2025-10-24","2025-10-24","2025-07-10","2024-02-20","2024-02-07","2024-02-07","2024-12-23","2024-12-23","2024-12-23","2024-12-23","2025-09-18","2025-09-18","2024-11-24","2024-11-24","2024-11-24","2024-11-24","2025-06-04","2025-06-04","2025-05-06","2024-12-09","2025-11-05","2024-10-31","2024-03-05","2024-12-17","2024-01-25","2023-10-26","2024-02-07","2025-07-23","2024-02-15","2024-02-15","2025-04-08","2024-03-19","2024-02-03","2024-02-03","2024-10-24","2024-10-24","2024-10-24","2025-07-15","2024-02-03","2024-02-03","2024-02-03","2025-07-15","2025-07-15","2025-04-08","2025-04-08","2023-12-11","2023-12-11","2024-02-03","2024-02-03","2023-10-19","2025-08-23","2024-01-25","2024-05-09","2024-05-09","2024-02-03","2024-02-03","2024-01-08","2025-02-20","2024-08-08","2025-09-18","2025-09-18","2024-08-08","2024-08-08","2025-09-18"],"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 TRIV 2024-25","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","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":""}]}]}