{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jane E Pryor","gend":1,"currentgend":"","add":"66 WILLIAMS RD","city":"PRESQUE ISLE","state":"ME","zip":"04769","dob":"1949-09-21","age":"","mstatus":"","insh":"10000064526","cliId":"","pno":2077695931,"cno":"","email":"jepryor02@gmail.com","ename":"","eno":"","pphy":"MCFADGEN, ROBERT L","ppno":2077643142,"pcpadd":"TAMC Family Practice and Internal Medicine,23 North St Ste 4","pcpcity":"Presque Isle","pcpstate":"ME","pcpzip":"04769","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE PRESQUE ISLE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"66 WILLIAMS RD","madd2":"","madd3":"","mcity":"PRESQUE ISLE","mstate":"ME","mzip":"04769","pcpfaxno":2077608170,"pcpnpi":1689025959,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7N88C66CD59","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E1136","Z48810","D485","L821","L918","L304","Z7189","E1165","L570","D225","L814","E113213","I10","I4891","L820","D0361","Z1231","Z23","H903","Z0001","C44519","D0461","Z961","Z794","H259","H43812","I4819","N83209","E119","Z7984","Z7901","K7460","K2980","K2100","K449","K5730","K648","Z86010","I480","K7581","K7400","E6601","H2589","Z87891","E7800","H538","E1139","I358","Z0000","R6889","Z136","R92323","K2970","K640","K2900","R195","I080","D352","Z01812","E8342","Z01818","Z1331","Z0100"],"date":["2023-06-08","2023-07-24","2023-06-26","2025-02-21","2023-06-26","2025-02-21","2023-06-26","2025-09-08","2025-02-21","2025-02-21","2025-02-21","2025-07-28","2023-06-08","2023-06-08","2025-02-21","2023-07-18","2025-05-23","2024-11-08","2024-08-29","2024-08-26","2023-06-26","2023-07-18","2024-03-28","2024-03-28","2023-02-21","2023-02-21","2024-10-23","2024-10-21","2023-09-06","2023-10-09","2023-09-06","2024-10-11","2023-01-09","2023-02-01","2023-01-09","2023-02-01","2023-01-09","2023-02-01","2023-10-24","2025-09-10","2022-11-07","2022-11-07","2022-10-28","2023-12-12","2022-10-24","2023-08-23","2023-08-23","2024-10-23","2025-09-02","2023-11-27","2023-10-24","2025-05-23","2023-01-09","2023-02-01","2023-01-09","2022-10-31","2023-10-24","2023-09-30","2023-01-06","2023-04-04","2023-03-24","2023-08-22","2022-07-27"],"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":[["","","OZEMPIC","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ONETOUCH VERIO TEST STRIP","","","Select","Select",""],["","","NANO 2ND GEN PEN NEEDLE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","NYSTOP","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","TRESIBA FLEXTOUCH U-100","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","METFORMIN HCL ER","","","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":""}]}]}