{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Edward C Oliver","gend":0,"currentgend":"","add":"33 FOXGLOVE LN","city":"SIDNEY","state":"ME","zip":"04330","dob":"1954-06-05","age":"","mstatus":"","insh":"10000068796","cliId":"","pno":2074652896,"cno":"","email":"Eoliver1954@yahoo.com","ename":"","eno":"","pphy":"HANNON, GAVIN","ppno":2074657342,"pcpadd":"Northern Light Health Center Unity,80 Main St","pcpcity":"Unity","pcpstate":"ME","pcpzip":"04988","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT HEALTH CENTER UNITY","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"33 FOXGLOVE LN","madd2":"","madd3":"","mcity":"SIDNEY","mstate":"ME","mzip":"04330","pcpfaxno":8606454151,"pcpnpi":1992327696,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2JJ8F98TE38","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H938X9","Z01818","Z1211","Z860100","K5730","K648","T783XXA","G8918","M1711","E785","E669","D3132","X58XXXA","M25571","G8929","M79672","F4542","Z9989","G4733","Z471","D492","L821","D1801","L814","D225","M24572","M24571","R269","M19071","E6601","M25561","H2511","H2512","D210","Z0000","M170","Z96643","Z125","Z23","M1731","T1490XS","X58XXXS","H9190","S99922A","E8881","H02831","H02834","H2513","M25461","R221","R200","M47812","L820","H40013","H43813","R1310","T783XXD","D649","Z85828","H40003","H25813","N390","R220","C4441","R300","L570","Z0101","M2351"],"date":["2024-05-10","2024-05-10","2024-10-11","2024-10-11","2024-10-11","2024-10-11","2025-05-27","2024-05-16","2024-05-16","2024-09-18","2024-05-16","2025-07-29","2025-05-27","2025-05-28","2023-09-04","2023-12-20","2023-09-04","2023-09-04","2025-08-25","2024-07-12","2025-09-22","2025-09-22","2025-09-22","2025-09-22","2025-09-22","2023-12-20","2023-12-20","2023-12-20","2025-05-28","2024-12-06","2024-09-18","2025-06-23","2025-07-07","2024-05-24","2024-05-22","2023-05-26","2023-05-26","2023-07-10","2023-01-05","2024-05-16","2024-05-16","2024-05-16","2024-05-24","2023-08-26","2023-07-10","2024-09-06","2024-09-06","2024-09-06","2024-05-30","2024-06-09","2024-06-09","2024-06-09","2025-09-22","2024-08-09","2025-07-29","2024-06-09","2024-08-07","2024-08-07","2023-09-18","2024-06-21","2024-06-21","2022-11-10","2022-11-10","2022-11-17","2022-11-06","2022-09-19","2022-09-14","2022-07-13"],"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":[["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","MINOCYCLINE HCL","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","EZALLOR SPRINKLE","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","FLUOROURACIL","","","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":""}]}]}