{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"David Bradford","gend":0,"currentgend":"","add":"42 NORTH BIRCH ST","city":"GREENVILLE JUNCTION","state":"ME","zip":"04442","dob":"1951-10-15","age":"","mstatus":"","insh":"10000051236","cliId":"","pno":2072804093,"cno":2076953594,"email":"d_pbradford@hotmail.com","ename":"","eno":"","pphy":"KNOWLTON, LUCAS T","ppno":2078764811,"pcpadd":"4720 S I 10 SERVICE RD W STE 301,","pcpcity":"METAIRIE","pcpstate":"LA","pcpzip":"70001124","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE SANGERVILLE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 149","madd2":"","madd3":"","mcity":"GREENVILLE JUNCTION","mstate":"ME","mzip":"04442","pcpfaxno":5048857642,"pcpnpi":1205119831,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2UU3NA3PR97","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z5181","R29898","I4891","M5417","Z7901","M21371","Z08","N401","L570","L2089","L814","L821","D225","I871","I872","R200","M48061","L309","Z7189","G629","Z0000","Z0100","M5127","M47817","L03115","C609","D0760","R3989","C601","Z79899","M5116","M4726","M4316","R32","Z8549","G608","G6289","M5416","H25813","H338","D3132","H4912","L089","Z87891","R21","Z85828","D0919","M7989","M47816","M438X6","M549","L308","R600","D485","N138"],"date":["2025-08-28","2024-03-19","2025-07-10","2025-01-29","2024-04-25","2025-03-10","2025-03-25","2024-03-29","2025-06-16","2025-06-16","2025-06-16","2025-06-16","2025-06-16","2024-12-30","2024-12-30","2025-03-10","2024-12-10","2024-03-22","2023-12-20","2025-01-29","2024-08-08","2024-07-08","2024-11-07","2024-11-07","2024-05-16","2024-05-10","2024-05-10","2024-05-24","2024-04-09","2024-08-29","2024-10-11","2024-10-11","2024-10-11","2024-05-28","2025-03-25","2024-05-03","2024-05-03","2024-05-03","2025-07-28","2025-07-28","2025-07-28","2025-07-28","2024-05-17","2024-06-14","2023-12-08","2024-08-29","2024-05-10","2025-03-10","2024-12-10","2024-12-10","2024-12-10","2022-10-06","2022-10-06","2022-10-06","2022-08-12"],"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":[["","","ZORYVE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","WARFARIN SODIUM","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","GEMFIBROZIL","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","TACROLIMUS","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","VALSARTAN","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ALCLOMETASONE DIPROPIONATE","","","Select","Select",""],["","","FINASTERIDE","","","Select","Select",""],["","","SILVER SULFADIAZINE","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","DUPIXENT PEN","","","Select","Select",""],["","","CLOTRIMAZOLE-BETAMETHASONE","","","Select","Select",""],["","","VALACYCLOVIR","","","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":""}]}]}