{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Cynthia A Vollero","gend":1,"currentgend":"","add":"608 STETSON RD","city":"NEWPORT","state":"ME","zip":"04953","dob":"1950-05-14","age":"","mstatus":"","insh":"10000040875","cliId":"","pno":2073414458,"cno":"","email":"declined@121924.com","ename":"","eno":"","pphy":"ARCEO, REYNALDO A","ppno":2074875154,"pcpadd":"470 SOMERSET AVE,","pcpcity":"PITTSFIELD","pcpstate":"ME","pcpzip":"49674928","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE PITTSFIELD","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"608 STETSON RD","madd2":"","madd3":"","mcity":"NEWPORT","mstate":"ME","mzip":"04953","pcpfaxno":2074873158,"pcpnpi":1144347196,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9U78FH6QQ47","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I4811","L820","D485","D225","L821","L814","Z08","M7601","Z90710","M79652","N83201","I4819","Z1231","Z98890","M47812","R6889","E559","E1165","R059","Z48812","M7910","Z0000","M47816","E1140","M216X2","M2042","M216X1","M2041","I498","N838","M25551","I428","I4892","I10","I081","I480","M7071","N839","J189","Z0100","H35372","M71551","E1142","J069","I083","I4891","J45909","I83893","L905","R0602","J4520","J849","Z0001","I3481","I517","K7689","H6121","J029","I83812","E039","B370","I872","C44319","L570","I83813","I83892","C44311","M5137","M5136","M5126","M47817","E782","I4821","H04123","H2513","L929","I83891","D2262","D3611","R062","R0989","R058","M25572","M25571","I739","R918","M9900","I493","M25562","C44612","G8929","M5450","Z7189","Z23","S8992XA","W19XXXA","M25531","Z7901"],"date":["2025-05-28","2025-03-25","2025-09-08","2025-03-25","2025-03-25","2025-03-25","2025-03-25","2023-05-25","2023-06-01","2023-02-06","2024-11-14","2023-10-27","2023-08-28","2025-06-18","2024-01-15","2023-12-19","2023-04-28","2025-07-23","2024-12-13","2025-09-29","2025-03-19","2024-09-25","2024-04-17","2022-12-28","2023-03-27","2022-12-28","2023-03-27","2022-12-28","2023-05-26","2023-06-01","2024-05-29","2023-02-05","2023-02-05","2023-02-05","2025-05-28","2022-12-05","2024-05-29","2024-11-15","2024-12-10","2025-01-28","2025-04-16","2023-08-24","2025-06-19","2023-12-31","2025-05-28","2024-01-31","2023-08-08","2025-08-05","2023-04-04","2025-10-02","2025-10-02","2025-10-02","2025-10-01","2023-10-27","2023-10-27","2023-10-27","2023-12-31","2023-12-31","2025-06-03","2023-03-07","2023-03-07","2024-11-25","2025-09-23","2025-09-23","2025-02-25","2024-06-12","2025-03-25","2023-10-23","2023-05-25","2023-05-25","2023-05-25","2025-09-25","2025-09-25","2025-04-16","2025-04-16","2025-09-08","2024-10-23","2023-04-04","2023-04-04","2022-10-31","2022-10-31","2022-10-31","2022-09-26","2022-09-26","2022-09-14","2022-08-16","2022-08-29","2022-07-06","2022-06-01","2022-04-18","2022-03-28","2022-03-28","2022-03-22","2021-12-20","2021-12-13","2021-12-13","2021-12-13","2021-12-13"],"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":[["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","DILTIAZEM 24HR ER (CD)","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","CARTIA XT","","","Select","Select",""],["","","METHOCARBAMOL","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","DOFETILIDE","","","Select","Select",""],["","","MODERNA COVID (12Y UP)VAC(EUA)","","","Select","Select",""],["","","AZELASTINE 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":{"indx":[["","","",""],[],[""],[""],[],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","",""],[],[""],[""],[""],[""],[""],[""]],"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":""}]}]}