{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda F Hobbs","gend":1,"currentgend":"","add":"41 RIVER RD APT D10","city":"BRUNSWICK","state":"ME","zip":"04011","dob":"1954-08-28","age":"","mstatus":"","insh":"10000088357","cliId":"","pno":2073705459,"cno":"","email":"declined@091622.com","ename":"","eno":"","pphy":"Newcombe, Jodi A","ppno":2075351200,"pcpadd":"385 ROUTE 1,","pcpcity":"YARMOUTH","pcpstate":"ME","pcpzip":"40966729","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT MERCY PRIMARY CARE YARMOUTH","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"41 RIVER RD APT D10","madd2":"","madd3":"","mcity":"BRUNSWICK","mstate":"ME","mzip":"04011","pcpfaxno":2075351249,"pcpnpi":1114339611,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1D58K09QU59","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z780","M549","R000","R1011","R5383","R110","G8929","Z1231","D120","D123","K5090","E559","N6323","Z0001","Z1211","Z23","K5010","M5136","M5126","M5134","I10","E804","F1190","Z0000","N6320","K5730","M5416","F4322","Z79620","Z0101"],"date":["2023-12-27","2025-06-02","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2023-12-27","2024-03-06","2024-03-06","2024-05-07","2024-03-06","2022-11-10","2025-01-07","2024-03-06","2023-11-10","2025-04-16","2022-08-25","2022-08-25","2022-08-25","2024-05-07","2023-09-18","2023-03-07","2023-09-18","2022-11-21","2024-03-06","2024-05-07","2024-05-07","2025-04-16","2024-08-09"],"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":[["","","HUMIRA(CF) PEN","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","ABRYSVO","","","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":""}]}]}