{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linnette E Pride","gend":1,"currentgend":"","add":"52 RICKS WAY","city":"BUXTON","state":"ME","zip":"04093","dob":"1952-07-10","age":"","mstatus":"","insh":"10000093416","cliId":"","pno":2077494614,"cno":"","email":"linnpride52@gmail.com","ename":"","eno":"","pphy":"Petropoulos, Maria Theresa C","ppno":2078399101,"pcpadd":"11 HEATHER LOCH,","pcpcity":"NORTH YARMOUTH","pcpstate":"ME","pcpzip":"40976431","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT MERCY PRIMARY CARE S PORTLAND","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"52 RICKS WAY","madd2":"","madd3":"","mcity":"BUXTON","mstate":"ME","mzip":"04093","pcpfaxno":2078399201,"pcpnpi":1568988137,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4PD8ER1TE54","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F330","Q780","M810","M9904","M9905","M9902","M9903","I2510","M1711","Z96652","Z471","Z96651","I493","Z8249","R030","R0789","S46812A","S134XXA","Z1231","M5450","M25572","M25571","M25562","M9908","M1612","Z7982","Z01818","R5383","G8918","M8588","M1712","I10","F419","M5489","Z955","K219","M9907","Z96653","Z9289","M2241","Z8279","Z4789","M25552","H40013","Z959","Z79899","Z0101","L578","L814","Z85828","L649","I340","G4700","F418","M549","M170","H43812","M2292","R6889","M160","E785","M47812","M542","R002","T8484XA","M25062","Z0000","Z01812","Z23","M19072","M76822","M25372","M79672","S76012A","S76011A","Z0100","M546"],"date":["2022-09-12","2025-04-28","2025-04-28","2025-06-09","2024-09-23","2025-06-09","2025-06-09","2025-06-06","2023-12-12","2023-06-28","2024-12-16","2024-03-05","2023-06-22","2023-04-18","2023-04-19","2023-04-19","2025-05-15","2025-05-15","2025-03-06","2024-02-21","2024-02-21","2022-12-08","2024-02-21","2025-06-09","2023-06-28","2024-06-25","2023-11-21","2024-02-21","2023-12-12","2024-04-11","2024-06-26","2024-06-25","2022-11-15","2023-04-18","2024-06-25","2023-12-12","2025-02-03","2024-12-16","2024-07-02","2023-12-12","2024-03-28","2024-06-06","2023-08-08","2023-04-07","2023-05-05","2023-05-05","2023-04-07","2024-10-17","2024-10-17","2024-10-17","2024-10-17","2023-06-22","2023-12-05","2022-09-12","2025-04-02","2023-11-21","2024-07-19","2022-12-19","2022-08-10","2023-06-28","2023-03-23","2025-04-28","2025-04-28","2023-04-18","2022-11-15","2022-11-15","2023-06-05","2022-11-12","2023-09-20","2023-05-10","2023-05-10","2023-05-10","2022-08-01","2023-08-03","2023-08-03","2024-06-05","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":[["","","ULTRA-FINE MINI PEN NEEDLE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ACETAMINOPHEN-CODEINE","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ATENOLOL","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FINASTERIDE","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","UNIFINE PENTIPS PLUS","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","MINOXIDIL","","","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":""}]}]}