{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael Griffin","gend":0,"currentgend":"","add":"15 WAYSIDE RD","city":"Portland","state":"ME","zip":"04102","dob":"1951-04-05","age":"","mstatus":"","insh":"10000042226","cliId":"","pno":2073298235,"cno":"","email":"griffginger@aol.com","ename":"","eno":"","pphy":"NEWCOMBE, JODI A","ppno":2075351200,"pcpadd":"385 ROUTE 1,","pcpcity":"YARMOUTH","pcpstate":"ME","pcpzip":"40966729","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT MERCY PRIMARY CARE YARMOUTH","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"15 WAYSIDE RD","madd2":"","madd3":"","mcity":"Portland","mstate":"ME","mzip":"04102","pcpfaxno":2075351249,"pcpnpi":1114339611,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5U18QD7EM49","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01818","I4811","M5450","I4820","M47816","M5010","M4722","R0683","R0609","K921","K7400","J449","K219","I2510","I350","F1020","K7689","M48062","I4891","Z0000","R9720","C61","I081","I700","Z87891","I513","I517","R5383","M50121","Z4789","M549","M5412","R109","R195","Z7409","F331","F418","Z79891","M47812","F332","R7401","D229","L578","L821","L814","L570","H903","I480","I10","Z48812","Z01810","H5111","R351","R4182","H01001","Z79890","D1039","M48061","Z7901","N529","I083","R931","Z981","H04123","Z7189","Z4682","K2950","Z1211","Z1212","D123","K621","M25476","L718","K829","R1011","K760","F5221","M51360","M542","J90","J9811","R0602","H2513","M4802","Z98890","R945","R2241","Z0001","R29898","M4316","H938X3","R197","Z20822","J22","R051","F32A","M40204","R6889","G8929","Z0100","K7402","F341","M461","M47817","Z23","I509","D649","M62838","R059","G4700","D2261","L820","L538","R208","L298","Z79899"],"date":["2025-03-18","2025-10-01","2025-05-23","2025-07-30","2024-09-09","2023-02-03","2023-02-03","2023-02-03","2023-02-03","2025-10-16","2025-10-16","2025-10-16","2025-10-16","2025-06-04","2025-01-14","2025-07-28","2025-08-04","2025-09-08","2025-07-03","2023-11-28","2024-02-22","2025-10-01","2025-03-28","2025-10-14","2025-09-05","2025-06-17","2025-03-28","2024-01-11","2023-02-03","2025-10-14","2025-10-02","2023-05-17","2023-07-20","2023-07-20","2025-06-04","2024-05-30","2025-07-03","2025-10-02","2023-03-29","2024-05-06","2025-07-28","2025-05-01","2025-05-01","2025-05-01","2024-05-09","2025-07-08","2024-11-14","2025-05-22","2025-02-27","2025-06-17","2025-03-11","2025-03-11","2025-01-14","2025-06-15","2023-08-24","2024-12-19","2023-09-01","2025-06-10","2025-07-03","2023-07-26","2025-02-27","2025-02-27","2025-10-14","2025-05-27","2024-04-25","2025-05-31","2025-10-16","2025-10-16","2025-10-16","2025-10-16","2025-10-16","2025-09-05","2025-05-01","2024-12-24","2024-12-24","2024-12-24","2023-01-18","2025-05-28","2023-05-17","2025-06-03","2025-06-03","2025-06-03","2025-01-02","2023-05-17","2023-05-17","2025-09-04","2025-09-05","2025-08-12","2025-05-23","2025-05-23","2025-04-24","2024-10-21","2022-12-27","2022-12-27","2022-12-27","2022-12-27","2024-10-02","2023-08-02","2025-04-15","2024-10-08","2025-04-11","2023-01-30","2025-04-15","2025-04-15","2022-12-12","2025-06-14","2022-11-09","2022-11-16","2022-11-16","2022-11-10","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-06-28"],"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":[["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","OXYCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","AMIODARONE HCL","","","Select","Select",""],["","","XIIDRA","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","ENOXAPARIN SODIUM","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","WARFARIN SODIUM","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","FLUTICASONE-SALMETEROL","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","DILT-XR","","","Select","Select",""],["","","RESTASIS","","","Select","Select",""],["","","TORSEMIDE","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","ENDOCET","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","NALTREXONE HCL","","","Select","Select",""],["","","TOBRAMYCIN-DEXAMETHASONE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","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":""}]}]}