{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda C Boyce","gend":1,"currentgend":"","add":"208 TOWN LINE RD","city":"LEE","state":"ME","zip":"04455","dob":"1959-05-21","age":"","mstatus":"","insh":"10000115160","cliId":"","pno":2072904423,"cno":"","email":"lboyce0521@gmail.com","ename":"","eno":"","pphy":"HOUSE, JESSICA","ppno":2077946700,"pcpadd":"175 West Broadway,","pcpcity":"Lincoln","pcpstate":"ME","pcpzip":"04457","pcpcounty":"","pcpid":"","pcpname":"HEALTH ACCESS NETWORK","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"208 TOWN LINE RD","madd2":"","madd3":"","mcity":"LEE","mstate":"ME","mzip":"04455","pcpfaxno":2077946777,"pcpnpi":1205070968,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9CU9AP3ET28","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z1231","Z780","M810","Z0101","H2513","K388","K219","K449","R1010","R079","N94819","Z1211","Z8619","L900","N200","Z48815","K2090","D124","K319","Z98890","R490","R070","R12","N83201","N898","R319","R945","E7800","Z13820","B001","Z0000","M5136"],"date":["2025-06-25","2025-06-25","2025-06-30","2024-10-25","2024-10-25","2025-11-17","2025-07-02","2025-07-02","2025-07-02","2025-07-04","2024-08-30","2024-08-26","2024-08-26","2024-08-26","2025-06-20","2025-07-03","2024-08-26","2024-08-26","2024-08-26","2025-10-22","2025-04-28","2025-04-28","2025-04-28","2024-05-08","2024-05-20","2025-01-24","2025-09-04","2025-09-04","2025-06-30","2025-09-10","2025-08-15","2024-06-17"],"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":[["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","LIDOCAINE HCL","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","AMITRIPTYLINE HCL","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","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":""}]}]}