{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Robert A Garrecht","gend":0,"currentgend":"","add":"323 BACK RIDGE RD","city":"Orland","state":"ME","zip":"04472","dob":"1944-04-03","age":"","mstatus":"","insh":"10000025958","cliId":"","pno":2074692525,"cno":2074695610,"email":"4mainebehr@gmail.com","ename":"","eno":"","pphy":"HIGGINS, MARTIN","ppno":"","pcpadd":"Northern Light Primary Care,","pcpcity":"Ellsworth","pcpstate":"ME","pcpzip":"04605","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE ELLSWORTH","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"323 BACK RIDGE RD","madd2":"","madd3":"","mcity":"Orland","mstate":"ME","mzip":"04472","pcpfaxno":"","pcpnpi":1851917751,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7HV6H51JF49","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D472","Z87891","N390","D649","G4733","R238","D479","M9905","M5459","M9908","M4004","H401131","H35033","H538","H43393","M85852","N281","M8580","K626","B009","L989","M5450","R531","R262","R9720","M19049","Z0000","I77810","Z299","J449","N401","H9113","R222","D509","I10","Z202","Z79624","H348320","Z13820","H26493","H532","H43813","C9000","R778","B078","M19011","Z5189","H35352","H401132","B889","Z20828","I351","H2513","Z2981","G5602","Z7252","Z113","Z79899","H3581","B079","M9901","M4712","M9903","M9902","H2512","Z9189","R509","M25562","Z4789","J101","H401122","C8510","R768","R6889","K909","K200","R3912","E7800","M549","E215","N3946","G250","Z206","N433","I872","Z7189","N3941","L299","R600","R079","L03314","N189","R718","R7982","D631","E213","Z881","Z888","Z9109","R7989","R85613","H401130","H2511","Z0101","H5213","E349","N451","J22","Z48816","Z114","J984","G20","Z23","H43812","H47022","H2589","Z01812","K625","D123","K2980","K3189","K219","Z139","R32","N400","N5089","Z880"],"date":["2025-09-03","2025-04-03","2024-10-21","2025-03-12","2025-08-16","2024-06-20","2025-06-02","2025-03-20","2025-03-20","2025-03-20","2025-03-20","2025-04-23","2025-07-10","2025-04-23","2025-03-17","2024-08-21","2025-02-19","2025-06-30","2023-10-06","2023-10-06","2023-10-26","2024-05-10","2024-05-10","2024-05-10","2023-09-08","2023-09-08","2023-09-08","2023-09-08","2025-03-03","2025-01-13","2024-03-27","2023-09-12","2025-05-08","2024-07-16","2024-02-05","2025-03-03","2024-06-24","2025-07-10","2024-08-21","2025-04-23","2025-04-23","2025-07-10","2025-05-08","2025-02-24","2023-10-26","2024-07-30","2024-02-13","2023-11-28","2025-01-23","2025-04-25","2024-05-30","2023-10-10","2024-08-21","2025-03-03","2025-08-07","2023-11-01","2023-11-01","2023-11-01","2025-06-10","2023-10-26","2023-03-30","2023-03-30","2023-03-30","2023-03-30","2025-01-16","2022-11-17","2024-10-21","2023-03-30","2025-02-07","2025-01-13","2025-01-16","2025-09-03","2025-01-06","2025-04-14","2023-05-09","2022-10-24","2025-07-30","2023-05-09","2023-02-15","2022-12-02","2022-11-15","2023-05-02","2023-04-27","2023-04-24","2025-08-28","2025-01-08","2025-07-17","2025-09-05","2025-09-11","2025-01-10","2023-01-30","2023-01-27","2023-01-06","2023-08-30","2023-01-03","2023-01-03","2023-01-09","2023-01-09","2023-01-09","2023-01-05","2025-06-30","2025-01-16","2025-01-23","2025-07-14","2025-07-14","2022-12-19","2024-10-23","2025-01-13","2023-02-01","2023-07-26","2025-09-11","2022-10-27","2022-09-22","2022-08-19","2022-08-19","2022-08-19","2022-07-14","2022-07-15","2022-07-15","2022-07-15","2022-07-15","2022-07-15","2022-07-12","2022-07-12","2022-07-12","2022-07-05","2022-07-06"],"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":[["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","DESCOVY","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","BROMFENAC SODIUM","","","Select","Select",""],["","","FAMCICLOVIR","","","Select","Select",""],["","","LUMIGAN","","","Select","Select",""],["","","CICLOPIROX","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","BREO ELLIPTA","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUTICASONE-VILANTEROL","","","Select","Select",""],["","","CEFADROXIL","","","Select","Select",""],["","","PERMETHRIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","CARBIDOPA-LEVODOPA","","","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":""}]}]}