{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ruth A Morgan","gend":1,"currentgend":"","add":"40 STATE ST APT 1","city":"GORHAM","state":"ME","zip":"04038","dob":"1947-11-30","age":"","mstatus":"","insh":"10000032992","cliId":"","pno":2073032760,"cno":"","email":"kirwinmorgan@gmail.com","ename":"","eno":"","pphy":"MCKENNEY, BRANDY M","ppno":2078399101,"pcpadd":"Mercy Gorham Crossing Primary Care,19 S Gorham Crossing","pcpcity":"Gorham","pcpstate":"ME","pcpzip":"04038","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT MERCY PRIMARY CARE GORHAM","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"40 STATE ST APT 1","madd2":"","madd3":"","mcity":"GORHAM","mstate":"ME","mzip":"04038","pcpfaxno":2078399201,"pcpnpi":1659458511,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7PQ2HA6GT15","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E119","G894","I10","Z79899","Z87891","A4159","R4182","R5381","N390","N184","N3642","N9089","L900","K219","R4020","R410","G4700","N904","N3090","L439","N393","N3080","A419","H8110","G9341","Z66","J189","S21002A","S21001A","R300","N952","R3989","R531","Z7401","R109","R350","R8290","Z794","Z7952","L602","R2689","G609","L608","B372","R32","E6601","Z23","L292","J9601","Z743","D649","N1830","F323","J029","N94818","D509","E538","N762","D071","R7881","I129","Z0000","Z79891","N903","L989","R3915","N3946","E1122","N1832","D631","E785","G4733","S51812A","L280","L853","L539","R454","F418","L2989","X58XXXA","K5730","J439","N179","N189","E0849","N2581","R059","J3489","R6889","M5450","E1140","R110","H9191","L258","N3000","L03113","Z87440","F331","R630"],"date":["2025-10-08","2025-10-23","2025-10-23","2025-10-23","2025-10-23","2023-12-16","2025-01-12","2024-06-26","2024-08-09","2025-05-09","2024-05-21","2024-05-21","2024-05-21","2024-05-21","2025-01-12","2025-02-18","2024-09-19","2024-06-06","2024-06-26","2024-05-23","2024-05-21","2024-05-21","2025-01-14","2025-01-17","2025-01-14","2025-01-14","2025-01-14","2025-04-11","2025-07-01","2024-06-11","2024-04-15","2024-04-01","2025-02-18","2025-02-18","2024-08-09","2024-08-09","2024-09-04","2024-06-10","2024-04-05","2024-10-02","2024-10-02","2024-02-13","2024-02-13","2023-01-10","2023-01-03","2024-09-27","2023-01-03","2024-03-11","2025-01-14","2025-01-14","2025-01-17","2025-07-11","2025-08-04","2024-06-11","2024-02-20","2024-04-12","2024-02-20","2024-02-12","2024-09-27","2024-06-26","2024-09-04","2023-05-22","2025-05-19","2024-05-21","2025-03-15","2023-09-18","2023-09-18","2024-04-12","2024-02-23","2024-02-23","2024-09-27","2024-01-03","2022-12-12","2024-09-27","2025-05-09","2024-11-18","2024-11-18","2024-09-27","2025-07-01","2025-07-01","2025-01-12","2025-01-12","2023-12-18","2023-12-18","2023-07-10","2023-07-10","2024-02-28","2024-02-28","2024-09-27","2023-05-22","2024-07-29","2024-06-06","2024-07-29","2024-05-03","2025-02-18","2025-10-08","2022-07-25","2022-07-25","2022-07-25"],"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":[["","","SPIKEVAX 2025-2026 (12Y UP)","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","BASAGLAR KWIKPEN U-100","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","METHENAMINE HIPPURATE","","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE ER","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","RISPERIDONE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","FREESTYLE LANCETS","","","Select","Select",""],["","","FREESTYLE TEST STRIPS","","","Select","Select",""],["","","NOVOLOG","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","INSULIN SYRINGE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","","","Select","Select",""],["","","LANTUS","","","Select","Select",""],["","","INSULIN ASPART","","","Select","Select",""],["","","CEFPODOXIME PROXETIL","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","INSULIN GLARGINE","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","NANO 2ND GEN PEN NEEDLE","","","Select","Select",""],["","","GEMTESA","","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","CEFDINIR","","","Select","Select",""],["","","ULTICARE","","","Select","Select",""],["","","BUPROPION HCL SR","","","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":""}]}]}