{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kim Archer","gend":0,"currentgend":"","add":"140 BAGLEY RD","city":"Mapleton","state":"ME","zip":"04757","dob":"1954-05-01","age":"","mstatus":"","insh":"10000080211","cliId":"","pno":"2075512155","cno":"","email":"kdarcher@roadrunner.com","ename":"","eno":"","pphy":"DARRELL, KIRSTEN","ppno":"2077692025","pcpadd":"Pines Kimball Community Health Center,66 Spruce St Ste 4","pcpcity":"Presque Isle","pcpstate":"ME","pcpzip":"04769","pcpcounty":"","pcpid":"","pcpname":"PINES KIMBALL COMMUNITY HEALTH CENTER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"140 BAGLEY RD","madd2":"","madd3":"","mcity":"Mapleton","mstate":"ME","mzip":"04757","pcpfaxno":"","pcpnpi":"1518145101","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5EH0TP6QF19","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E782","Z125","N400","N5201","R6889","D500","N3090","Z23","M542","I2510","D509","S4991XA","S46011A","H35033","H2513","H2512","H53021","D508","M25511","W19XXXA","M75121","H938X2","Z98890","Z4889","H6122","Z01818","H35032","H3581","H35371","H25811","I119","H903","K2270","H9193"],"date":["2023-09-12","2023-09-20","2023-09-20","2023-09-20","2023-08-12","2023-09-28","2023-09-28","2023-10-18","2023-11-13","2023-11-20","2023-12-01","2024-01-05","2024-03-07","2024-03-14","2023-12-13","2023-12-13","2023-12-13","2024-02-02","2024-07-09","2024-01-31","2024-03-07","2024-03-04","2024-07-09","2024-04-19","2024-03-14","2024-02-16","2024-03-21","2024-03-21","2024-03-13","2024-03-13","2024-04-23","2024-05-23","2024-06-05","2024-07-10"],"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":[["","","Spikevax","","","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":""}]}]}