{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda M Trask","gend":1,"currentgend":"","add":"12 STEPHANIE DR","city":"DRESDEN","state":"ME","zip":"04342","dob":"1945-04-06","age":"","mstatus":"","insh":"10000101928","cliId":"","pno":"2077372834","cno":"","email":"declined@10102024.com","ename":"","eno":"","pphy":"TRAPP, KATHLEEN R","ppno":"2077984400","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 - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"12 STEPHANIE DR","madd2":"","madd3":"","mcity":"DRESDEN","mstate":"ME","mzip":"04342","pcpfaxno":"2078287850","pcpnpi":"1386603397","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4AJ4MD1YW02","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":["B351","M79674","M79675","D500","I8501","E039","E119","E782","M25562","M1712","M79644","M79645","M1612","Z8542","M180","M152","M064","M0579","K7460","K7689","M7989","R160","R600","L03115","M25511","M25531","K317","I8510","K219","M25461","M25561","M79604","M7121","R932","M79605","M25462","M7122","Z0001","M79671","K635","M2011","N2889","R161","M5126","M47816","M4316","M549","M5450","G8929","M48061","M25519","R509","E1142","L600","R262","Z08","D649","K449","I8500","M19071","I87303","Z23","Z0100","D3131","M25571","N200","N3289","Z87442","E785","D729","Z79891","Z0000","M542","R4182","I700","J929","A419","N390","E1165","A4151","E611","R790","E118","R531","D7589","Z79899","R000","I10","R739","R5381","M5030","M4802","M8580","H6121","H6693","I499","M65971","R011","M5412","E66811","M62838","M25552","R102","M160","M7062","R1030","M79652","R1032","M79662","M79606","H6123"],"date":["2024-06-27","2024-06-27","2024-06-27","2025-12-23","2025-03-18","2026-03-09","2026-01-30","2023-05-02","2024-01-18","2024-01-14","2023-08-01","2023-08-01","2023-07-18","2025-09-23","2023-06-06","2023-06-06","2023-08-01","2025-10-10","2025-07-16","2023-08-31","2024-01-14","2023-08-31","2023-09-03","2023-09-12","2024-08-20","2023-09-12","2024-11-13","2023-10-25","2024-11-13","2023-11-09","2023-11-09","2023-11-09","2023-11-09","2023-12-22","2024-01-14","2024-01-18","2024-01-14","2024-03-05","2024-03-29","2024-08-09","2024-03-29","2024-04-26","2024-04-26","2024-04-26","2024-06-11","2024-04-26","2024-04-26","2024-04-25","2024-08-20","2024-06-11","2024-06-14","2024-06-14","2024-06-27","2024-06-27","2024-06-27","2025-03-26","2025-12-23","2024-11-13","2024-11-13","2025-04-02","2025-10-09","2025-10-29","2025-11-10","2025-11-10","2025-02-14","2024-12-18","2024-12-18","2024-12-18","2026-03-09","2025-06-09","2025-03-07","2025-12-20","2025-12-20","2025-06-04","2025-06-04","2025-06-04","2025-07-10","2025-06-04","2026-03-09","2025-06-05","2025-06-09","2025-06-09","2025-06-09","2025-06-05","2025-07-16","2026-03-09","2025-06-04","2025-09-18","2025-09-18","2025-09-18","2025-10-10","2025-10-10","2025-10-10","2025-10-13","2024-09-22","2025-09-18","2025-01-18","2023-03-30","2026-01-30","2026-01-30","2026-01-30","2023-03-15","2023-03-15","2023-03-15","2023-03-07","2023-03-07","2023-03-07","2023-03-02","2023-03-15","2023-03-15","2023-02-12"],"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":""}]}]}