{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Peter R Horton","gend":0,"currentgend":"","add":"364 GRAYTOWN RD","city":"Sedgwick","state":"ME","zip":"04676","dob":"1949-10-27","age":"","mstatus":"","insh":"10000035611","cliId":"","pno":2073264334,"cno":2074605858,"email":"phorton@myfairpoint.net","ename":"","eno":"","pphy":"MURNIK, MICHAEL G","ppno":"","pcpadd":"Blue Hill Family Medicine,65 Water St","pcpcity":"Blue Hill","pcpstate":"ME","pcpzip":"04614","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE BLUE HILL","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"364 GRAYTOWN RD","madd2":"","madd3":"","mcity":"Sedgwick","mstate":"ME","mzip":"04676","pcpfaxno":2073743991,"pcpnpi":1972540110,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2Y87VA3AG52","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I498","R531","T7849XD","J3089","R7889","M11261","M1711","I493","Z23","G5602","R29898","K219","H608X3","J370","L720","M25561","Z0100","H35363","Z471","Z96612","L578","L821","L218","L570","D485","M25571","M19071","Z01818","Z0000","M47812","R6889","Z87891","Z131","M12812","Z77128","J309","R911","C4491","L111","C44319","R4701","I959","R29818","M75121","H6063","C4441","D044","R509","L820","L905","M19012","M19011","R430","I4891","R002","G8929","G4700","Z7729","H353131","M542","N401","T148XXA","R21","I2510","M5031","E785","Z0001","R5383","M25511","T50915A","M1811","M720","M19031","Z20822","U071"],"date":["2025-04-03","2023-09-27","2024-03-20","2024-03-20","2024-03-20","2022-10-07","2022-10-07","2024-01-15","2024-10-01","2025-07-31","2025-07-22","2023-11-01","2023-11-01","2024-06-11","2024-12-12","2022-10-07","2025-05-14","2023-06-06","2025-08-05","2025-07-09","2024-10-14","2024-10-14","2024-10-14","2024-10-14","2023-02-20","2022-12-02","2022-12-02","2025-05-16","2025-09-23","2023-09-26","2023-11-09","2023-05-24","2023-09-12","2025-06-17","2022-12-08","2022-12-08","2024-09-20","2023-02-20","2023-02-20","2023-03-17","2024-06-12","2024-08-26","2024-08-26","2025-06-17","2024-06-11","2023-03-30","2023-03-30","2024-09-06","2023-04-05","2023-04-05","2025-05-16","2025-03-10","2023-05-01","2024-09-10","2023-11-22","2025-02-17","2023-03-02","2023-03-02","2025-05-14","2023-03-16","2023-03-20","2025-04-23","2024-06-27","2023-10-09","2023-05-24","2023-11-07","2022-09-14","2022-08-09","2022-09-09","2022-08-25","2022-08-31","2022-08-31","2022-08-31","2022-07-11","2022-07-13"],"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":[["","","CELECOXIB","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","PENTOXIFYLLINE","","","Select","Select",""],["","","FINASTERIDE","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","OXYCODONE 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":""}]}]}