{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda L Pinelli","gend":1,"currentgend":"","add":"17 FLAG COVE RD","city":"Bowerbank","state":"ME","zip":"04426","dob":"1947-07-16","age":"","mstatus":"","insh":"10000020855","cliId":"","pno":2075642356,"cno":"","email":"LLAP716@YAHOO.COM","ename":"","eno":"","pphy":"BEALE, CATHERINE M","ppno":"","pcpadd":"Northern Light Primary Care Milo,135 Park St","pcpcity":"Milo","pcpstate":"ME","pcpzip":"04463","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE MILO","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"17 FLAG COVE RD","madd2":"","madd3":"","mcity":"Bowerbank","mstate":"ME","mzip":"04426","pcpfaxno":2079431002,"pcpnpi":1760912885,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8J30QD0AQ34","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L280","Z0000","Z1231","I8001","R0683","R5383","Z299","Z13820","Z780","M8589","Z0101","H5203","H524","H52223","E039","I4891","I340","I361","Z0001","L821","I4819","Z7901","Z8249","Z87891","H2513","N952","R42","M8580"],"date":["2024-11-05","2025-01-13","2024-10-15","2024-11-13","2025-01-22","2025-01-22","2025-01-09","2025-01-22","2025-01-22","2025-01-22","2025-06-24","2025-06-24","2025-06-24","2025-06-24","2023-10-31","2025-07-14","2023-08-17","2023-08-17","2023-01-09","2024-04-11","2023-06-06","2023-06-06","2023-06-06","2023-06-06","2023-11-28","2022-11-01","2025-08-04","2023-11-02"],"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":[["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","WARFARIN SODIUM","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","MECLIZINE HCL","","","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":""}]}]}