{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Peter D Curran","gend":0,"currentgend":"","add":"268. FERN ST","city":"BANGOR","state":"ME","zip":"04401","dob":"1947-06-03","age":"","mstatus":"","insh":"10000054064","cliId":"","pno":2079455380,"cno":2077459202,"email":"Curran268@roadrunner.com","ename":"","eno":"","pphy":"CRANE, SARAH J","ppno":2078629400,"pcpadd":"43 WHITING HILL RD,SUITE 300","pcpcity":"BREWER","pcpstate":"ME","pcpzip":"44121005","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE HAMPDEN","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"268. FERN ST","madd2":"","madd3":"","mcity":"BANGOR","mstate":"ME","mzip":"04401","pcpfaxno":2078629411,"pcpnpi":1083913735,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4J93WE1XF82","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C679","N3090","Z48812","L570","D225","L821","L814","Z7189","D485","Z01812","Z08","Z85828","I4821","M1711","I4819","I129","E1122","N182","C44619","C44712","Z96651","Z01810","C678","I352","I4891","E119","M1712","D649","Z87891","Z800","Z936","R319","Z7901","I350","C672","N132","N1832","I10","E559","M1990","Z483","M5136","M47816","M4316","R0602","Z432","I471","M5450","M25561","M25661","I517","Z95818","R6889","Z5111","N200","Z471","Z01818","Z0000","I2510","I2720","M170","M21161","E7800","Z09","Z0101","H31002","J9811","N281","H5213","Z8551","I4892","I493","Z98890","Z96659","E785","R4182","C44719","R8289","D229","J069","Z906","I77810","R918","R310","I4720","R059","I080","M11262","R188","Z7689","Z466","C44319","I480","Z0001","C4491","L989"],"date":["2025-08-25","2024-08-29","2025-06-26","2025-04-08","2025-04-08","2025-04-08","2025-04-08","2025-04-08","2025-04-08","2023-07-05","2025-05-20","2024-04-23","2025-05-19","2023-07-27","2023-11-01","2023-11-01","2023-11-01","2023-11-01","2023-11-27","2023-11-27","2025-04-29","2023-06-02","2025-07-01","2025-02-24","2025-05-27","2024-12-31","2024-04-16","2025-01-17","2024-10-01","2024-10-01","2025-07-30","2023-10-24","2024-10-21","2025-07-14","2024-03-08","2023-10-27","2025-01-17","2025-07-09","2025-01-17","2023-06-21","2024-10-10","2022-12-02","2022-12-02","2022-12-02","2025-05-27","2024-10-17","2022-11-30","2022-12-12","2025-04-29","2023-10-12","2024-10-21","2025-07-03","2022-11-25","2025-08-04","2025-02-03","2023-10-10","2024-08-20","2024-12-19","2025-07-09","2025-07-09","2023-08-03","2023-07-19","2023-07-19","2025-04-29","2022-11-18","2025-01-17","2024-03-04","2025-02-03","2025-01-17","2024-10-25","2024-04-28","2024-04-28","2023-08-01","2023-08-01","2024-08-29","2024-08-29","2025-04-08","2023-11-13","2024-04-23","2025-05-27","2024-12-10","2023-03-27","2025-05-13","2024-01-26","2022-10-21","2024-05-30","2024-07-19","2024-04-16","2025-02-03","2024-05-17","2024-02-02","2022-09-07","2022-07-29","2022-07-15","2022-07-15","2022-07-08"],"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":[["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"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":""}]}]}