{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Margaret B Jones","gend":1,"currentgend":"","add":"281 FLANDERS CORNER ROAD","city":"WALDOBORO","state":"ME","zip":"04572","dob":"1950-08-14","age":"","mstatus":"","insh":"10000042669","cliId":"","pno":5402465910,"cno":2078321181,"email":"MAGGIEB2U@GMAIL.COM","ename":"","eno":"","pphy":"STOUT, LISA M","ppno":2075644464,"pcpadd":"897 W MAIN ST,","pcpcity":"DOVER FOXCROFT","pcpstate":"ME","pcpzip":"44261029","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT FAMILY MEDICINE AND RESIDENCY","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"281 FLANDERS CORNER ROAD","madd2":"","madd3":"","mcity":"WALDOBORO","mstate":"ME","mzip":"04572","pcpfaxno":2075644461,"pcpnpi":1346549979,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6XK4HG2QJ83","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z5181","I10","C50912","M85832","Z780","Z0000","C50212","Z853","R92323","M19012","I4710","I890","H26491","E039","Z23","Z5112","Z136","H40003","D329","Z79811","M85851","M25512","R931","Z1731","R002","Z79899","D320","Z510","S62635B","N62","M85852","C50812","Z170","Z9221","E782","H2512","S62635A","S6992XA","N6481","E785","I69354","H2513","Z961","L219","Z5111","Z98890","N6489","R928","Z800","Z8041","Z808","H2511","I517","L603","L602","L600","M79674","M2011","M2012","I081","I361","I3481","I083","I5030","D229","N6011","N6012","D239","R059","J9811","D2272","D701","R079","R0902","R4182","N6321","N6325","N6322"],"date":["2025-10-15","2025-03-27","2025-10-15","2025-02-12","2025-02-12","2025-10-01","2025-09-03","2025-08-29","2025-08-29","2025-03-27","2025-03-26","2025-08-29","2025-04-17","2025-10-01","2025-10-01","2025-04-08","2025-01-28","2025-01-30","2025-01-10","2025-02-12","2025-02-12","2025-03-27","2025-10-15","2025-10-15","2025-02-07","2025-04-10","2025-01-10","2023-03-03","2024-05-06","2022-12-28","2023-04-04","2023-03-01","2023-08-25","2022-12-28","2024-05-03","2023-12-19","2024-06-27","2024-05-06","2022-12-06","2023-12-05","2022-12-28","2023-12-05","2024-01-29","2023-11-13","2023-05-30","2024-08-28","2024-03-04","2023-08-25","2023-01-09","2023-01-09","2023-01-09","2023-12-05","2023-10-25","2023-01-06","2023-01-06","2023-01-06","2023-01-06","2023-01-06","2023-01-06","2024-04-22","2024-04-22","2023-04-13","2023-04-13","2023-04-13","2023-04-19","2022-12-28","2022-12-28","2024-03-14","2022-10-13","2022-10-13","2022-08-24","2022-08-04","2022-07-21","2022-07-21","2022-07-12","2022-06-13","2022-06-13","2022-06-13"],"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":[["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","LETROZOLE","","","Select","Select",""],["","","NIFEDIPINE ER","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","PROCHLORPERAZINE MALEATE","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}