{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joyce M Allard","gend":1,"currentgend":"","add":"99 STETSON RD E","city":"LEVANT","state":"ME","zip":"04456","dob":"1951-09-09","age":"","mstatus":"","insh":"10000092699","cliId":"","pno":2078847099,"cno":"","email":"declined@032524.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":"99 STETSON RD E","madd2":"","madd3":"","mcity":"LEVANT","mstate":"ME","mzip":"04456","pcpfaxno":2079476720,"pcpnpi":1033152582,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2EM4W92CC99","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I441","N179","N184","D649","E8351","I480","E1165","Z7689","R0600","Z0000","E039","M7989","R001","Z1231","K635","E119","D509","Z9884","R109","N1830","K900","D500","T183XXA","R222","K909","I10","Z09","D62","Z45018","E1122","R197","I081","R140","K5521","R590","I130","M5030","M47812","R942","I2510","Z98890","Z23","N200","J984","E860","K921","J90","J9811","N1832","E871","N1831","I509","E876","S0003XA","R42","R0602","I5030","K625","I495","I4891","R208","S161XXA","E8770","K3182","N281","K529","K5730","M47819","T82110A","I440","I5033","Z950","I5032","K5520","K922","M542","R221","E785","R918","I70223","R3915","R5382","Z03821","N189","Z95818","R921","Q2730","Z4682","R0989","N6489","K31811","R300","R3589","Z951","R2243","X58XXXA","Z7984","I7389","Z95820","Z7902","I70212","I708","I129","I739","I771","Z79899","I70213","I700","Z7982"],"date":["2023-10-09","2025-05-12","2025-06-10","2025-06-10","2025-04-21","2025-08-29","2025-06-10","2025-02-17","2024-07-22","2025-03-20","2024-08-20","2025-04-11","2024-04-25","2025-03-24","2024-05-17","2025-07-01","2025-01-16","2024-01-19","2023-12-27","2024-06-17","2025-01-16","2025-05-22","2023-12-21","2025-03-03","2025-01-16","2025-06-01","2025-05-21","2024-06-02","2025-10-03","2024-08-16","2023-12-18","2025-05-27","2025-05-14","2024-08-30","2024-12-17","2025-06-17","2024-12-17","2024-12-17","2025-05-05","2024-08-14","2023-11-20","2023-11-16","2023-12-27","2023-12-27","2023-06-17","2025-04-18","2023-12-11","2023-12-11","2024-05-20","2024-05-20","2024-08-02","2025-05-23","2024-08-02","2025-02-19","2025-02-19","2025-03-04","2024-08-18","2023-07-11","2023-10-04","2025-02-10","2025-03-20","2024-10-14","2025-05-12","2025-03-04","2024-05-13","2023-07-11","2023-07-11","2024-12-17","2024-05-03","2023-09-11","2024-07-29","2024-05-12","2024-10-01","2024-06-28","2024-06-28","2024-12-04","2024-12-04","2025-03-20","2023-12-09","2024-04-10","2025-09-05","2023-08-02","2023-12-21","2025-04-04","2025-03-31","2025-03-24","2025-01-16","2024-05-16","2024-05-16","2025-03-24","2024-05-31","2023-01-19","2023-01-19","2023-01-19","2024-05-22","2024-10-14","2022-11-03","2022-11-14","2022-11-14","2022-11-14","2022-10-12","2022-10-12","2022-10-12","2022-09-12","2022-09-12","2022-09-12","2022-03-28","2022-03-28","2022-03-28"],"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":[["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","DILTIAZEM 24HR ER (CD)","","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","BUMETANIDE","","","Select","Select",""],["","","HYDRALAZINE HCL","","","Select","Select",""],["","","TOUJEO SOLOSTAR","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","OZEMPIC","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}