{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Arthur E Buck","gend":0,"currentgend":"","add":"73 WALTON ST","city":"Portland","state":"ME","zip":"04103","dob":"1932-10-17","age":"","mstatus":"","insh":"10000040370","cliId":"","pno":"2077725710","cno":"","email":"","ename":"","eno":"","pphy":"CROTHERS, DANIEL S","ppno":"2078282402","pcpadd":"Martins Point Health Care,331 Veranda St","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04103","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"73 WALTON ST","madd2":"","madd3":"","mcity":"Portland","mstate":"ME","mzip":"04103","pcpfaxno":"2078282433","pcpnpi":"1336601996","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9DA7A51QY68","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":["D6942","N1831","E211","R6889","H353132","Z13228","I7143","I723","I10","I890","Z95828","E209","J449","M810","R410","R55","J9601","N179","G9389","I083","J90","J181","J9811","R2243","I4510","I5031","J441","G3184","R5381","J439","T17300A","R091","D649","R69","Z95818","J189","R918","R600","J4489","E860","I5022","K5900","B351","M79674","M79675","L603","I130","I5033","I21A1","Z515","R0902","I708","D472","K5641","H6123","N1832","N189","I499","Z87891","N261","C44622","D0461","R0603","R932","I701","I7142","T82310A","R0602","R7989","L578","D225","L814","L821","L570","D492","N184","R9431","D696","K769","K739"],"date":["2023-04-12","2025-09-11","2024-02-28","2023-12-29","2023-07-12","2023-09-08","2025-08-13","2023-09-19","2025-09-18","2023-09-19","2025-08-18","2023-11-02","2025-12-12","2023-11-02","2024-02-07","2025-12-19","2026-01-08","2025-08-14","2024-02-02","2024-02-05","2026-01-06","2024-02-05","2024-03-20","2024-02-05","2024-02-07","2024-02-10","2026-01-08","2024-02-05","2024-02-05","2024-02-09","2024-02-07","2024-02-10","2024-05-29","2024-03-07","2025-09-18","2024-03-20","2024-03-20","2024-04-22","2024-04-26","2024-05-03","2024-04-22","2025-11-13","2024-07-10","2024-07-10","2024-07-10","2024-07-10","2026-01-03","2026-01-03","2026-01-03","2026-01-06","2025-07-17","2025-08-13","2024-12-09","2025-03-15","2025-07-17","2024-11-06","2025-11-05","2025-11-05","2024-09-13","2026-01-03","2025-12-22","2025-08-22","2026-01-03","2025-12-24","2025-08-13","2025-08-18","2025-08-18","2026-01-03","2025-10-03","2025-08-22","2025-08-22","2025-08-22","2025-08-22","2025-08-22","2025-08-22","2025-08-14","2026-01-03","2025-07-17","2025-12-24","2026-01-05"],"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":[]},{"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":""}]}]}