{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James L Lennox","gend":0,"currentgend":"","add":"33 THUNDER CASTLE RD","city":"Readfield","state":"ME","zip":"04355","dob":"1945-07-24","age":"","mstatus":"","insh":"10000030840","cliId":"","pno":2076206445,"cno":"","email":"j_lennox@msn.com","ename":"","eno":"","pphy":"KATZ, JAMES A","ppno":2077711717,"pcpadd":"144 STATE ST,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41013776","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT MERCY INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2074413808,"add2":"","add3":"","madd1":"33 THUNDER CASTLE RD","madd2":"","madd3":"","mcity":"Readfield","mstate":"ME","mzip":"04355","pcpfaxno":2077711727,"pcpnpi":1588605604,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5HF4PH4EQ85","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","Z01818","J432","J984","Z48812","S72002A","I6340","H903","R600","I6523","F4320","Z471","W109XXA","K7689","I214","E785","F17210","Z96642","I6782","R9089","R410","R918","J9811","Z01810","R0989","Z48813","I2510","I5022","I429","I110","I2582","J349","J449","J90","Z98890","R160","R0602","M160","S79819A","W19XXXA","R079","J439","I080","I501","R931","M542","Z87891","Z951","Z0000","I679","Z0100","H353130","S72002D","M62838","I700","I3489","I253","I639","I358","I517","I5189","L728","L821","D229","Z85828","L570","R001","I4710","I4720","L720","L700","L718","R0981","I25119","I252","J189","J9600","D72829","R3589","L309","I493","Z23","M109","K219"],"date":["2025-11-05","2024-12-19","2023-01-28","2023-02-22","2023-02-14","2025-01-06","2024-12-27","2024-04-01","2024-12-24","2024-12-24","2023-08-16","2025-03-28","2024-12-19","2023-01-30","2023-02-07","2023-03-22","2023-01-31","2025-03-28","2024-12-24","2024-12-24","2024-12-24","2025-06-11","2024-12-20","2023-01-28","2024-12-19","2023-01-28","2025-10-30","2024-12-23","2024-12-23","2024-12-23","2023-01-31","2023-01-31","2025-06-11","2023-02-22","2023-02-06","2023-01-31","2024-12-20","2024-12-19","2024-12-19","2024-12-19","2023-01-25","2023-02-10","2023-01-30","2023-01-30","2023-01-30","2024-09-05","2023-09-26","2023-08-01","2025-06-11","2025-01-21","2024-06-24","2023-06-23","2025-01-03","2024-09-05","2024-12-27","2024-12-27","2024-12-27","2025-02-04","2024-12-19","2024-12-19","2024-12-19","2024-04-25","2025-04-02","2025-04-02","2025-04-02","2025-04-02","2023-01-10","2025-02-04","2025-02-04","2024-04-25","2024-04-25","2024-04-25","2023-08-01","2023-03-22","2023-03-22","2023-02-07","2023-02-07","2023-03-01","2023-03-01","2023-03-23","2022-11-25","2022-10-28","2022-07-22","2022-07-22"],"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":[["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","IPRATROPIUM-ALBUTEROL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","TRETINOIN","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","TORSEMIDE","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","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":""}]}]}