{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Hugh E Cummings","gend":0,"currentgend":"","add":"119 BATES ST","city":"MILLINOCKET","state":"ME","zip":"04462","dob":"1950-03-09","age":"","mstatus":"","insh":"10000075360","cliId":"","pno":2074476886,"cno":"","email":"sigmashorty@yahoo.com","ename":"","eno":"","pphy":"RONCO, PAUL G","ppno":2079476141,"pcpadd":"43 WHITING HILL RD,SUITE 300","pcpcity":"BREWER","pcpstate":"ME","pcpzip":"44121005","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"119 BATES ST","madd2":"","madd3":"","mcity":"MILLINOCKET","mstate":"ME","mzip":"04462","pcpfaxno":2079476720,"pcpnpi":1033152582,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5X27ER6KX39","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z5181","Z86010","R5383","Z23","N189","R6883","R6889","Z0001","N132","N281","K7689","K5730","Z09","M2550","I10","Z125","M542","N200","M549","N131","Z87891","R195","H40033","M9903","M5137","M5417","M62830","R109","R519","R361","G8929","N1330","K529","Z0100","H259","J029","K429","Z1211","Z800","K635","D509","R079","R5382","I82402","I80201","Z7901","Z0000","N135","N138","R509","R0609","N289","Z87448","Z86718","M5030","N261","N1339","Z87442","M5450"],"date":["2025-08-12","2023-02-07","2025-05-14","2024-10-22","2024-05-09","2025-05-14","2023-01-09","2023-07-12","2024-02-19","2023-12-20","2023-12-20","2023-12-20","2023-02-22","2024-07-26","2024-12-18","2023-07-12","2025-08-12","2024-12-18","2025-08-12","2022-10-18","2025-05-02","2024-08-01","2023-02-02","2022-11-14","2022-11-14","2022-11-14","2022-11-14","2024-09-17","2022-12-08","2024-02-19","2023-01-19","2023-01-13","2024-09-20","2025-02-12","2025-02-12","2025-05-02","2023-01-13","2023-02-22","2023-02-22","2023-02-22","2024-12-18","2025-05-09","2025-03-19","2023-06-13","2023-06-13","2024-07-09","2024-07-22","2023-01-19","2024-12-18","2024-12-03","2025-05-09","2024-02-19","2024-02-19","2024-07-09","2024-07-22","2022-09-22","2022-08-11","2022-08-11","2022-06-27"],"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":[["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","JANTOVEN","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","DOXAZOSIN MESYLATE","","","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":""}]}]}