{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Judy A Townsend","gend":1,"currentgend":"","add":"1000 HUDSON HILL RD","city":"HUDSON","state":"ME","zip":"04449","dob":"1955-09-25","age":"","mstatus":"","insh":"10000081358","cliId":"","pno":2078847166,"cno":"","email":"","ename":"","eno":"","pphy":"DAVIS, ALLISON L","ppno":2072853435,"pcpadd":"PO BOX 3649,400 E FIFTH AVENUE","pcpcity":"SPOKANE","pcpstate":"WA","pcpzip":"99202364","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE CORINTH","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1000 HUDSON HILL RD","madd2":"","madd3":"","mcity":"HUDSON","mstate":"ME","mzip":"04449","pcpfaxno":2075641284,"pcpnpi":1881019370,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2DY6UT4UE61","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z1231","M5104","Z0000","G5603","G5623","R531","G464","I4891","Z01818","I10","Z8673","M79604","I480","Z7901","Z79899","M79605","Z1211","M79606","M4714","M5416","M5031","M47812","M4312","M4804","M51369","M5116","Z5181","M5134","I253","S134XXA","G629","I499","M4802","M4313","M5417","Z993","M549","E785","I440","I252"],"date":["2025-02-07","2025-08-08","2025-05-19","2025-06-04","2025-06-04","2025-10-30","2025-10-30","2025-09-30","2025-08-05","2025-07-16","2025-09-30","2025-02-14","2024-01-12","2024-01-12","2025-07-15","2025-02-14","2024-12-03","2025-02-14","2025-08-05","2025-03-26","2025-08-05","2025-08-05","2025-08-05","2025-08-05","2025-06-26","2025-04-18","2023-01-11","2025-06-26","2025-09-30","2025-07-22","2025-04-02","2024-10-23","2025-06-26","2025-06-26","2025-04-02","2025-07-22","2025-07-02","2024-11-18","2024-10-25","2024-10-25"],"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":[["","","ELIQUIS","","","Select","Select",""],["","","MULTAQ","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","CALCITRIOL","","","Select","Select",""],["","","CHLORTHALIDONE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","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":""}]}]}