{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Mary B Casey","gend":1,"currentgend":"","add":"21 STATE PARK RD","city":"NAPLES","state":"ME","zip":"04055","dob":"1958-10-08","age":"","mstatus":"","insh":"10000109435","cliId":"","pno":2076539988,"cno":"","email":"mkc5484@gmail.com","ename":"","eno":"","pphy":"SAUCIER, NICOLE M","ppno":2076936106,"pcpadd":"Naples Family Practice,410 Roosevelt Trl","pcpcity":"Naples","pcpstate":"ME","pcpzip":"04055","pcpcounty":"","pcpid":"","pcpname":"NAPLES FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"21 STATE PARK RD","madd2":"","madd3":"","mcity":"NAPLES","mstate":"ME","mzip":"04055","pcpfaxno":2076934026,"pcpnpi":1467094656,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8TP3U55KK90","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M069","M159","Z79899","R6889","Z1231","C50812","M8589","C50919","Z0100","C50912","Z13820","C50212","N6322","M1990","Z510","Z1211","Z0000","Z17411","H6691","Z170","Z1721","Z13220","Z13228","E559","R928","C7A8","C50312","R590","L598","M8580"],"date":["2025-06-13","2025-06-13","2025-06-13","2023-12-11","2025-04-17","2025-07-15","2024-07-15","2025-08-21","2024-01-31","2025-08-21","2024-07-15","2025-09-09","2025-05-15","2024-12-12","2025-09-09","2023-11-17","2025-04-24","2025-08-14","2024-11-29","2025-07-31","2025-07-15","2023-11-20","2023-11-20","2025-05-16","2025-07-15","2025-06-18","2025-07-31","2025-06-18","2025-09-09","2024-12-12"],"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":[["","","HYDROXYCHLOROQUINE SULFATE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","METHOTREXATE","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","LETROZOLE","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","CEFDINIR","","","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":""}]}]}