{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Cole E Ridley","gend":0,"currentgend":"","add":"12 RIVER CITY DR UNIT D","city":"BREWER","state":"ME","zip":"04412","dob":"1953-10-02","age":"","mstatus":"","insh":"10000078523","cliId":"","pno":2076999531,"cno":"","email":"cridley1002@gmail.com","ename":"","eno":"","pphy":"KNIPSCHER, KATHLEEN A","ppno":2079890550,"pcpadd":"Eastern Maine Medical Center,43 Whiting Hill Rd","pcpcity":"Brewer","pcpstate":"ME","pcpzip":"04412","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE BREWER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"12 RIVER CITY DR UNIT D","madd2":"","madd3":"","mcity":"BREWER","mstate":"ME","mzip":"04412","pcpfaxno":2079890551,"pcpnpi":1376071894,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2F57GC7RX32","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R002","R001","F1010","H02883","H02886","H11823","L03012","I10","Z87891","H6982","L989","C4359","Z0001","G5602","J310","S90852A","X58XXXA","H9193","H6123","H1045","H2513","L570","H6980","F0670","R4189","Z0000","Z636","B349","H109","Q134","Z0101","H524","H25813","H903","R202","J069","H6992","C44319","Z23","Z711","Z8249","R1310","K219","R200","H6122","H52223","B309","M50321","Z974","R0600","E785","E663","G4730","Z1331","D485","F4322","F4320","Z79899","F1090","I999","F419","I499","Z125","F32A","I4720","I491","I493","L03019","L2089","L718","R6889","H6993","G4700","R0982","Z7189","Z08","Z85828","R4789","H938X2","D1801","L821","L814","G5622","Z1159","R197","Z7982","J0190","Z20822"],"date":["2025-04-08","2025-04-08","2023-11-08","2023-05-01","2023-05-01","2023-05-01","2024-06-04","2025-01-24","2025-11-03","2023-04-12","2024-01-31","2025-10-29","2025-07-29","2024-04-30","2023-03-03","2024-07-05","2024-07-05","2024-04-05","2023-12-08","2023-01-25","2024-03-25","2024-12-03","2024-04-05","2025-08-05","2025-08-05","2025-08-05","2025-08-05","2023-02-26","2023-02-26","2023-02-26","2024-03-25","2024-03-25","2023-03-22","2024-04-01","2024-04-05","2024-11-22","2024-11-22","2024-01-04","2023-07-21","2024-01-31","2024-01-31","2023-10-10","2023-10-10","2024-08-30","2024-04-11","2024-03-25","2023-02-27","2024-04-05","2023-10-10","2025-01-15","2024-08-06","2024-03-21","2024-03-21","2024-07-22","2025-06-03","2025-11-11","2025-11-11","2025-11-11","2025-07-02","2025-07-02","2025-11-03","2025-01-30","2024-08-06","2025-11-03","2025-03-03","2025-03-03","2025-03-03","2024-06-14","2024-06-14","2024-06-14","2023-01-20","2023-12-08","2025-01-02","2023-08-23","2025-11-12","2024-05-16","2024-05-16","2025-01-18","2024-04-05","2025-11-12","2025-11-12","2025-11-12","2024-04-30","2022-07-19","2022-07-22","2022-07-08","2022-06-30","2022-06-30"],"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":[["","","SPIKEVAX 2025-2026 (12Y UP)","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","BETAMETHASONE DIPROP AUGMENTED","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","FLUOCINOLONE ACETONIDE OIL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","LOTEPREDNOL ETABONATE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","SODIUM FLUORIDE","","","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":""}]}]}