{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Thornton A Andrews","gend":0,"currentgend":"","add":"94 REACH ROAD","city":"Brooklin","state":"ME","zip":"04616","dob":"1950-09-05","age":"","mstatus":"","insh":"10000043356","cliId":"","pno":2073592079,"cno":"","email":"","ename":"","eno":"","pphy":"KNIPSCHER, KATHLEEN A","ppno":2079890550,"pcpadd":"Eastern Maine Medical Center,43 Whiting Hill Rd","pcpcity":"Brewer","pcpstate":"ME","pcpzip":"04412","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE BREWER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 113","madd2":"","madd3":"","mcity":"Brooklin","mstate":"ME","mzip":"04616","pcpfaxno":2079890551,"pcpnpi":1376071894,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1VQ4PV8CJ98","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I6523","I739","Z96643","M9903","M5450","M9902","M9901","Z98890","I10","M9913","M9912","M9911","G5622","J849","M533","M810","Z79899","M109","I2720","M25551","Z96641","K824","R918","M25552","M4800","M7631","L820","M25531","L409","Z87891","M47816","G5602","M25532","M25511","M48061","H2012","H35372","H43811","H43812","D649","N179","E785","Z0130","I7389","Z7982","R0602","I70211","M8448XA","Z0000","I129","D125","M5136","M25571","R748","M5126","M5137","M47817","Z96642","M779","R194","M7989","H20012","H43813","R195","Z1211","Z86010","D122","D120","D123","Z471","Z8781","I6529","H21542","R600","E669"],"date":["2023-12-04","2023-12-04","2024-02-19","2023-06-14","2025-01-30","2023-06-14","2023-06-14","2024-12-09","2025-03-04","2024-03-27","2024-03-27","2024-03-27","2023-03-09","2025-02-03","2023-03-07","2023-03-07","2023-03-07","2025-09-09","2025-02-03","2024-02-19","2023-02-14","2025-01-27","2025-02-03","2024-03-27","2024-12-04","2023-09-06","2023-09-20","2025-06-17","2025-06-17","2025-06-17","2024-09-24","2023-01-10","2025-04-18","2023-09-13","2025-01-30","2024-05-31","2025-05-28","2024-05-31","2024-05-31","2024-12-11","2024-10-03","2023-03-09","2024-12-18","2022-11-28","2023-03-09","2023-07-10","2023-07-10","2023-07-10","2023-12-22","2024-02-06","2025-04-17","2023-03-07","2023-08-23","2025-01-27","2024-09-24","2024-09-24","2024-09-24","2024-05-14","2023-02-14","2025-04-17","2025-03-05","2025-05-28","2025-05-28","2025-03-14","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-08-09","2022-08-09","2022-08-08","2022-08-02","2022-06-29","2022-06-29"],"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":[["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","GAVILYTE-N","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","PEG 3350-ELECTROLYTE","","","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":""}]}]}