{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Mary B Thurlow","gend":1,"currentgend":"","add":"3 SNOW RD","city":"SCARBOROUGH","state":"ME","zip":"04074","dob":"1959-05-11","age":"","mstatus":"","insh":"10000115137","cliId":"","pno":2072866099,"cno":"","email":"Nestduck@aol.com","ename":"","eno":"","pphy":"KNIGHT, CARLEEN R","ppno":2077986200,"pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"3 SNOW RD","madd2":"","madd3":"","mcity":"SCARBOROUGH","mstate":"ME","mzip":"04074","pcpfaxno":2077986290,"pcpnpi":1043589443,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8AU8HG4NM23","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C50211","Z171","R4182","R928","T7840XA","M25561","N6312","Z01818","Z5112","C50811","Z803","D701","I4892","Z9189","Z136","Z98890","Z853","R634","Z5111","Z95828","Z23","H903","R92343","I361","Z452","Z510","N610","N6031","T50905A","R55","R252","R051","R530","T451X5A","Z8041","I440","Z8774","Z8679","C50919","N6489","Z0101","I081","Z08","Z923"],"date":["2025-08-13","2025-08-13","2024-11-06","2024-11-06","2024-07-17","2025-05-27","2024-11-05","2025-06-18","2025-04-23","2025-01-14","2024-12-12","2024-09-18","2024-07-17","2024-12-12","2024-08-07","2025-03-18","2025-07-02","2025-08-13","2025-03-04","2024-06-26","2024-11-20","2024-11-26","2025-07-02","2024-12-02","2025-06-24","2025-01-14","2024-11-06","2024-11-06","2024-07-17","2024-07-17","2024-07-17","2024-07-17","2025-01-03","2025-01-03","2024-09-30","2024-11-12","2024-11-12","2024-11-12","2025-06-24","2024-06-21","2025-01-30","2025-06-18","2025-04-24","2025-04-24"],"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":[["","","PROCHLORPERAZINE MALEATE","","","Select","Select",""],["","","TRAZIMERA","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","EPINEPHRINE","","","Select","Select",""],["","","ONDANSETRON HCL","","","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":""}]}]}