{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James M Boober","gend":0,"currentgend":"","add":"7 CUSHING DR","city":"BANGOR","state":"ME","zip":"04401","dob":"1941-03-19","age":"","mstatus":"","insh":"10000021563","cliId":"","pno":2079074929,"cno":"","email":"maineredbat@gmail.com","ename":"","eno":"","pphy":"Sidhu, Virinder","ppno":8145805600,"pcpadd":"302 HUSSON AVE STE 2,","pcpcity":"BANGOR","pcpstate":"ME","pcpzip":"44013373","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"7 CUSHING DR","madd2":"","madd3":"","mcity":"BANGOR","mstate":"ME","mzip":"04401","pcpfaxno":8144552584,"pcpnpi":1891292355,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4M68G13KN45","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R8289","Z5111","Z45018","Z13820","C61","R310","I4891","Z8546","N39498","Z9079","R3915","Z08","M8580","Z79818","Z923","G4733","Z01818","Z87891","Z950","N3021","G4700","K625","M25551","J8410","K5730","K8020","R9721","Z79899","Z01812","N3020","M85852","I509","E1122","N1830","D122","Z1211","R319","R590","R4586","I130","M160","Z510","Z7901","Z0000","M542","N3941","I4719","Z0101","I340","I517","R309","N393","R9720","S199XXA","S0990XA","Z9989","I480","I110","I5030","I4439","N1832","M62830","Z634","Z23","R6889","N3289","I129","R32","S21102A","W57XXXA","W000XXA"],"date":["2024-11-29","2024-10-22","2025-05-06","2024-08-29","2025-04-08","2025-01-13","2024-01-08","2025-04-23","2024-04-24","2024-11-19","2024-04-24","2024-10-22","2023-11-20","2023-11-20","2024-11-19","2025-04-01","2025-02-04","2025-04-01","2024-08-28","2025-02-21","2024-10-01","2024-03-25","2025-06-03","2022-08-11","2022-08-11","2022-08-11","2022-08-15","2024-10-01","2022-08-03","2025-02-21","2024-08-29","2024-01-08","2024-01-08","2024-01-08","2024-03-25","2024-03-25","2024-11-22","2022-09-22","2023-03-10","2023-04-13","2023-08-22","2023-01-03","2025-03-11","2023-06-29","2025-03-11","2023-04-12","2025-05-12","2022-12-21","2025-05-12","2025-05-12","2024-10-28","2023-05-16","2022-09-22","2025-03-03","2025-03-03","2023-06-14","2023-03-02","2023-03-02","2023-03-02","2023-03-02","2025-04-30","2023-10-12","2023-10-12","2023-10-12","2023-02-08","2025-02-27","2025-04-29","2022-10-10","2025-04-25","2025-04-25","2025-03-03"],"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":[["","","ELIQUIS","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","TROSPIUM CHLORIDE ER","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","TROSPIUM CHLORIDE","","","Select","Select",""],["","","METHOCARBAMOL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","ACCU-CHEK AVIVA PLUS","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","MYRBETRIQ","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","ACCU-CHEK SOFTCLIX","","","Select","Select",""],["","","BOOSTRIX TDAP","","","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":""}]}]}