{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Mary A Harkins","gend":1,"currentgend":"","add":"52 POINT RD","city":"BERNARD","state":"ME","zip":"04612","dob":"1958-12-27","age":"","mstatus":"","insh":"10000111903","cliId":"","pno":2072449117,"cno":2074795154,"email":"Mary_harkins@outlook.com","ename":"","eno":"","pphy":"HANKE, TANYA","ppno":2072445630,"pcpadd":"10 WAYMAN LN,","pcpcity":"BAR HARBOR","pcpstate":"ME","pcpzip":"46091625","pcpcounty":"","pcpid":"","pcpname":"MDI COMMUNITY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 9","madd2":"","madd3":"","mcity":"BASS HARBOR","mstate":"ME","mzip":"04653","pcpfaxno":2072445515,"pcpnpi":1760644082,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9TM7T52WR51","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N281","N390","K5730","K828","E039","K7689","R1011","H35411","S82122A","S82141A","S8391XA","S7002XA","W010XXA","S82124D","S82131A","W19XXXA","Y9389","Y92002","S82141D","X58XXXD","S82234D","Z0130","W01198A","R350","H00016","S82131D","S82141B","S82201A","R2241","M25561","M1711","Z87440","N2889","X58XXXA","S8991XA","S79912A","S82121D","N289","K429","H527","H5319","Z139","H43811","S82144A","R300","R8289","S82841D","I10","E038"],"date":["2025-03-24","2024-11-11","2024-10-30","2024-07-08","2025-04-28","2024-03-22","2024-07-23","2025-02-06","2024-06-30","2025-03-03","2024-09-02","2024-09-02","2024-09-02","2024-07-12","2024-12-17","2024-09-16","2024-09-16","2024-09-16","2025-01-07","2025-01-22","2024-08-05","2025-05-13","2024-06-30","2024-01-30","2024-05-03","2025-01-22","2024-08-05","2024-11-14","2024-06-30","2024-06-30","2025-01-22","2024-04-30","2025-03-24","2024-12-17","2024-09-02","2024-09-02","2024-08-26","2024-03-22","2024-03-22","2025-04-03","2024-03-27","2024-11-11","2023-12-19","2024-06-30","2024-07-25","2024-11-11","2024-12-17","2025-04-28","2025-06-17"],"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":[["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","CEPHALEXIN","","","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":""}]}]}