{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kathleen A Huntley","gend":1,"currentgend":"","add":"92 ARNOLD RD","city":"South China","state":"ME","zip":"04358","dob":"1947-08-13","age":"","mstatus":"","insh":"10000018368","cliId":"","pno":2074454006,"cno":2073188909,"email":"","ename":"","eno":"","pphy":"SCHLEICH, DEBORAH M","ppno":"","pcpadd":"Northern Light Primary Care Clinton,1309 Main St","pcpcity":"Clinton","pcpstate":"ME","pcpzip":"04927","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE CLINTON","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"92 ARNOLD RD","madd2":"","madd3":"","mcity":"South China","mstate":"ME","mzip":"04358","pcpfaxno":2078617056,"pcpnpi":1700331030,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1EF4C98DH89","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R0600","J449","Z45010","T82110A","J42","I255","Z950","R42","R0602","E119","I214","R55","I081","Z952","Z09","R059","E8720","Z45018","E871","J441","I442","Z789","R918","Z743","Z20822","Z0130","Z0000","J439","I110","M25541","R0902","I2510","Z0101","H43813","Z1231","I10","R1110","J029","R0982","S0086XA","W57XXXA","T82190A","I252","T82119A","Y831","J370","I517","J440","I509","Z7982","Z9861","I083","Z01810","J9600","Z955","K219","K224","R6330","R079","T82897A","Z87891","Z79899","E1165","I119","E785","Z5189","J9601","N179","F419","D72829","R0789","J189","Z23","R000","I159","J984","Z452","E113293","D3132","Z961","J8410","Z780","Z13820","R112","R197","Z7984","I5023","I25110"],"date":["2025-03-21","2025-08-01","2023-09-06","2023-04-25","2023-04-25","2023-06-26","2023-10-02","2023-04-24","2025-02-15","2025-01-16","2025-02-15","2023-04-24","2023-04-24","2023-04-24","2023-10-20","2025-02-14","2023-10-20","2025-08-25","2023-02-28","2025-03-28","2023-06-14","2025-01-16","2025-07-24","2025-02-14","2023-09-25","2023-05-10","2024-04-22","2025-07-31","2024-09-13","2024-09-13","2025-02-14","2025-04-07","2024-02-05","2024-08-05","2024-04-22","2025-05-21","2024-07-08","2023-07-01","2023-07-01","2023-07-01","2023-07-01","2023-04-24","2023-05-12","2023-04-24","2023-04-24","2023-04-13","2023-04-13","2023-10-16","2025-03-05","2024-01-05","2022-11-23","2023-02-27","2024-05-22","2025-02-26","2023-05-12","2025-01-17","2025-01-17","2025-01-17","2024-07-09","2023-04-23","2025-05-21","2025-04-29","2025-05-21","2022-10-31","2022-10-31","2023-06-19","2025-03-05","2025-01-12","2025-01-16","2025-01-16","2024-07-08","2023-10-16","2023-07-13","2025-02-14","2023-02-28","2023-04-12","2023-10-18","2024-08-05","2024-08-05","2024-08-05","2024-01-07","2022-12-02","2022-12-02","2024-07-08","2024-07-08","2023-01-09","2023-03-01","2023-03-01"],"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":[["","","SPIRONOLACTONE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","INSULIN ASPART FLEXPEN","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","FREESTYLE LIBRE 3 READER","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","TOUJEO SOLOSTAR","","","Select","Select",""],["","","IPRATROPIUM-ALBUTEROL","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","BREZTRI AEROSPHERE","","","Select","Select",""],["","","FLUTICASONE-SALMETEROL","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","WIXELA INHUB","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","GLYBURIDE","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","BASAGLAR KWIKPEN U-100","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","INSULIN LISPRO KWIKPEN U-100","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","ULTRA-FINE MINI PEN NEEDLE","","","Select","Select",""],["","","ULTRA-FINE PEN NEEDLE","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","FREESTYLE LIBRE 3 PLUS SENSOR","","","Select","Select",""],["","","BRILINTA","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","ENTRESTO","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","CEFUROXIME","","","Select","Select",""],["","","BUDESONIDE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"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":""}]}]}