{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Francis J Flaherty","gend":0,"currentgend":"","add":"283 MILTON MILLS RD","city":"LEBANON","state":"ME","zip":"04027","dob":"1958-02-07","age":"","mstatus":"","insh":"10000105864","cliId":"","pno":"2076089844","cno":"","email":"","ename":"","eno":"","pphy":"BUSEY, MELANIE A","ppno":"2074906900","pcpadd":"Nasson Offsite Clinical Care,15 Oak St","pcpcity":"Springvale","pcpstate":"ME","pcpzip":"04083","pcpcounty":"","pcpid":"","pcpname":"NASSON OFFSITE CLINICAL CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"283 MILTON MILLS RD","madd2":"","madd3":"","mcity":"LEBANON","mstate":"ME","mzip":"04027","pcpfaxno":"2073240546","pcpnpi":"1477937894","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2FV6V32UM54","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0101","H524","L821","D2371","Z85820","Z808","C250","K760","K8689","Z1389","M86171","E11621","L97519","L97512","M86271","Z4789","T8131XA","T8131XD","E1141","L89892","L89899","S91301A","E119","E11610","S93119A","C7A8","R531","Z89411","E1151","B353","L97511","M720","E1140","F1010","R202","Z7984"],"date":["2025-06-17","2023-05-04","2024-12-19","2023-06-29","2024-12-19","2024-12-19","2026-02-03","2023-12-10","2023-12-10","2024-02-05","2024-02-27","2026-03-09","2026-02-16","2026-02-27","2024-03-18","2024-03-13","2024-03-27","2024-04-22","2024-04-15","2024-04-29","2024-05-06","2024-05-30","2025-06-17","2024-07-03","2026-01-21","2026-02-03","2025-08-14","2024-12-09","2025-06-19","2024-09-20","2026-03-09","2024-12-19","2023-03-10","2023-03-10","2023-03-10","2023-03-10"],"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":[["","","FLUZONE HIGH-DOSE","","","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":""}]}]}