{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kathleen I Lund","gend":1,"currentgend":"","add":"250 TANDBERG TRL APT 208","city":"WINDHAM","state":"ME","zip":"04062","dob":"1958-05-28","age":"","mstatus":"","insh":"10000111896","cliId":"","pno":"2073323515","cno":"","email":"kil528@yahoo.com","ename":"","eno":"","pphy":"SUBAK KRAH, SARAH","ppno":"2077745816","pcpadd":"100 FODEN ROAD WEST,SUITE 203","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"04106","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"250 TANDBERG TRL APT 208","madd2":"","madd3":"","mcity":"WINDHAM","mstate":"ME","mzip":"04062","pcpfaxno":"2078741483","pcpnpi":"1780643437","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1PV1GC0PW11","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0001","Z23","Z01818","M1711","A000","Z471","Z96651","I10","E669","G8918","M25461","Z0100","E119","R011","M1712","M25562"],"date":["2024-02-23","2024-02-23","2024-02-23","2024-06-28","2024-03-29","2024-06-28","2024-06-28","2024-03-27","2024-03-27","2024-03-27","2024-05-07","2024-06-10","2024-06-10","2024-06-14","2024-06-27","2024-06-27"],"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":[["","","Amoxicillin","500 MG","","Select","Select",""],["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Atorvastatin","20 MG","","Select","Select",""],["","","Bupropion Hcl","150 MG","","Select","Select",""],["","","Metformin","500 MG","","Select","Select",""],["","","Methylprednisolone","4 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Ascend Labs","","","Select","Select",""],["","","Losartan","100 MG","","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":""}]}]}