{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joellen R Chute","gend":1,"currentgend":"","add":"471 FULLER RD","city":"BANGOR","state":"ME","zip":"04401","dob":"1954-07-28","age":"","mstatus":"","insh":"00008166000","cliId":"","pno":2079447204,"cno":2079447204,"email":"jrcjewel53@gmail.com","ename":"","eno":"","pphy":"MCLAUGHLIN, SCOTT A","ppno":2079476141,"pcpadd":"43 WHITING HILL RD,300","pcpcity":"BREWER","pcpstate":"ME","pcpzip":"44121005","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE SANGERVILLE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"471 FULLER RD","madd2":"","madd3":"","mcity":"BANGOR","mstate":"ME","mzip":"04401","pcpfaxno":2079476720,"pcpnpi":1841220431,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6EM1WU2UC00","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":["K9089","Z933","Z9049","T82514A","K912","Z452","Z932","D508","D509","Z7982","R110","R197","F419","Z008","R0600","Z959","F331","I4720","Z0189","Z79899","Z5181","E860","R109","Z681","E43","R000","E041","D229","K529","M79662","H2511","Z0000","G90A","Z8673","K5000","L600","K580","Z5320","K90822","K638219","H2512","K90829","K909","T80212D","E876","G8929","Z95828","E8351","Z1231","Z85828","E878","D649","K219","R6889","Z792","Z992","M79661","M79672","M79671","E042","L570","Z0100","R609","R140","R112","M8589","T80211A","T80212A","R5383","R2242","H02403","H53021","H04123","R0789","Z8249","R0602","K5909","E611","T82898A","J9811","J432","M67471","M722","J101","R509","R002","J9801","Z20822","R079","M797","Z7902","K6389","M810"],"date":["2025-10-03","2025-10-03","2025-10-03","2023-05-19","2025-10-20","2025-10-27","2025-10-13","2025-04-01","2025-10-13","2025-02-26","2025-10-27","2023-08-11","2023-08-01","2023-05-27","2023-05-27","2023-05-27","2025-03-18","2024-03-14","2025-06-30","2025-02-17","2025-09-03","2024-12-30","2024-11-09","2025-09-03","2023-10-30","2023-10-30","2024-12-30","2025-07-28","2024-10-24","2025-01-22","2024-12-11","2024-08-27","2025-03-25","2025-04-28","2022-12-26","2025-10-31","2024-06-17","2025-05-19","2025-09-23","2025-09-23","2024-12-19","2025-08-01","2025-05-01","2025-01-20","2023-07-31","2023-07-31","2023-06-07","2023-07-24","2025-01-31","2025-07-28","2023-08-14","2025-01-28","2023-10-16","2023-11-03","2024-12-02","2025-09-29","2024-09-25","2024-09-25","2024-09-25","2024-12-30","2025-07-28","2024-08-09","2023-09-29","2025-10-27","2025-10-27","2023-11-22","2024-11-02","2023-05-23","2025-04-01","2025-01-22","2024-10-17","2024-10-17","2024-10-17","2024-03-14","2024-03-14","2023-09-25","2025-07-10","2025-07-01","2025-03-24","2024-11-13","2024-11-03","2024-10-31","2024-10-31","2022-11-29","2024-11-02","2023-09-18","2022-11-29","2022-11-29","2022-11-10","2022-11-10","2022-10-24","2022-11-13","2022-07-05"],"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":{"comment":"","sub":[["","","OMEPRAZOLE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","FLUVOXAMINE MALEATE","","","Select","Select",""],["","","LORAZEPAM INTENSOL","","","Select","Select",""],["","","AMITRIPTYLINE HCL","","","Select","Select",""],["","","CEFADROXIL","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","SCOPOLAMINE","","","Select","Select",""],["","","LACTULOSE","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","PREMARIN","","","Select","Select",""],["","","SODIUM CHLORIDE","","","Select","Select",""],["","","PRILOSEC","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","SUCRALFATE","","","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":""}]}]}