{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Cheryl A Robinson","gend":1,"currentgend":"","add":"47 LITTLE DEER ISLE RD","city":"LITTLE DEER ISLE","state":"ME","zip":"04650","dob":"1945-04-13","age":"","mstatus":"","insh":"10000007561","cliId":"","pno":2073482285,"cno":"","email":"declined@050824.com","ename":"","eno":"","pphy":"COBB, TIMOTHY A","ppno":2073672311,"pcpadd":"Northern Light Primary Care Stonington,354 Airport Rd","pcpcity":"Stonington","pcpstate":"ME","pcpzip":"04681","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE STONINGTON","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"47 LITTLE DEER ISLE RD","madd2":"","madd3":"","mcity":"LITTLE DEER ISLE","mstate":"ME","mzip":"04650","pcpfaxno":2073672805,"pcpnpi":1326557372,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3JC9PK2XD22","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25539","I10","S20211A","M810","M25561","M19011","M19012","Z0001","L2489","L03012","M109","R9389","N1832","D649","M654","Z124","Z1151","Z01419","N644","M1711","E538","M25531","L03011","L03019","M549","N1830","Z0100","R059","E559","M47816","N858","M160","M25511","J209","R600","L03031","M5134","M47814","R0781","R21","S61452A","H109","M79676","Z5189","S60552A","S60222A","W540XXA","I129","M25761","E66813","Z6843","Z1231","D61818","D72819","G8929","E669","M7989","R2241","D259","J189","M461","M48061","M5127","M5136","M47817","M5416","R0789","Z0000","R079","M1811","R0989","M5412","R519","M47812","M542","Z9989","M1990","M5124","M50322","G542","M21611","M79674","M79671","M19071","M2011","Z13820","Z23"],"date":["2023-01-27","2025-07-10","2025-01-02","2024-12-18","2024-02-28","2025-07-09","2025-07-09","2025-06-11","2023-06-20","2023-07-13","2025-07-10","2024-07-05","2025-07-10","2025-07-10","2023-05-04","2024-07-05","2024-07-05","2024-07-05","2025-01-02","2025-06-25","2024-01-02","2024-02-07","2024-12-01","2024-12-04","2022-11-23","2025-06-18","2025-01-24","2024-10-16","2025-06-04","2024-05-29","2024-07-05","2024-05-15","2025-03-26","2025-01-16","2023-09-20","2024-05-03","2025-04-30","2025-04-30","2025-04-30","2025-08-14","2023-07-11","2024-03-06","2024-05-10","2023-07-13","2023-07-11","2023-07-11","2023-07-11","2023-02-22","2025-06-25","2025-07-09","2025-07-09","2024-12-18","2024-04-17","2024-04-17","2025-04-09","2025-07-21","2023-09-13","2023-09-13","2024-06-10","2024-10-11","2023-03-24","2024-05-29","2024-05-29","2024-05-29","2024-05-29","2025-06-03","2025-04-16","2023-06-14","2025-04-16","2022-10-07","2024-10-16","2022-08-07","2022-08-07","2022-08-07","2022-08-15","2022-08-15","2022-08-07","2022-08-19","2022-08-15","2022-08-05","2022-07-18","2022-07-18","2022-07-20","2022-07-18","2022-07-18","2022-06-14","2022-06-16"],"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":[["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","POLYMYXIN B SUL-TRIMETHOPRIM","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","OMEPRAZOLE","","","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":""}]}]}