{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Norman E Lamson","gend":0,"currentgend":"","add":"18 PINE KNOLL DR","city":"SEBEC","state":"ME","zip":"04481","dob":"1939-10-16","age":"","mstatus":"","insh":"10000093894","cliId":"","pno":2075648786,"cno":"","email":"declined@01212025.com","ename":"","eno":"","pphy":"SHEPARD, NATHAN D","ppno":2075644464,"pcpadd":"Northern Light Primary Care Dover Foxcroft,891 W Main St Ste 200","pcpcity":"Dover Foxcroft","pcpstate":"ME","pcpzip":"04426","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE DOVER FOXCROFT","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"18 PINE KNOLL DR","madd2":"","madd3":"","mcity":"SEBEC","mstate":"ME","mzip":"04481","pcpfaxno":2075644461,"pcpnpi":1972778892,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9PX5PP0WN57","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z466","I10","I4891","Z48817","S71102A","X58XXXA","N401","C4499","R55","L929","R911","R1314","R339","L03116","C801","R229","K921","D485","L900","Z09","C4922","I480","D6869","T83031A","T86821","R338","H109","H1032","H5711","K4090","H11422","Z483","E876","L02414","Z98890","R2242","Z0000","L570","Z48816","T490X5A","M1612","Z4800","T819XXA","C44799","C3490","R918","Z428","J189","E119","J0390","I447","T1490XA","L03119","R82998","I160","R1319","I129","K449","E782","R208","L989","T18128A","I493","Z08","C44791","J8410","R791","R000","S0990XA","N281","S81802A","I158","R8290","L0390","E871","R09A2","Z0001","R1310","F4321","J984","R2240","Z7984","T83098A","T83021A","D481"],"date":["2022-11-28","2025-09-19","2025-06-01","2024-08-01","2024-09-05","2024-09-05","2025-03-28","2025-02-18","2023-06-20","2025-06-18","2025-08-04","2023-09-17","2022-10-25","2025-06-25","2024-04-19","2024-04-11","2023-06-30","2024-05-23","2025-01-08","2023-10-04","2024-06-04","2025-09-19","2025-01-07","2022-11-04","2024-09-05","2024-03-26","2025-05-19","2025-04-27","2025-04-27","2025-04-15","2025-05-11","2024-07-07","2024-10-24","2025-08-22","2025-06-30","2025-06-18","2025-09-09","2024-01-02","2022-12-20","2022-10-26","2024-05-01","2024-04-15","2024-07-10","2024-05-17","2024-07-05","2024-07-05","2024-06-12","2023-05-31","2024-12-03","2025-01-28","2024-07-08","2023-05-23","2024-07-03","2023-03-01","2023-09-16","2023-09-16","2023-09-16","2023-09-16","2023-10-04","2022-11-09","2022-11-09","2023-09-16","2023-07-14","2025-01-22","2025-01-22","2025-08-04","2023-05-23","2023-05-23","2023-05-23","2023-03-01","2024-06-20","2023-11-04","2023-02-21","2024-07-05","2024-01-24","2023-10-02","2025-09-09","2023-09-16","2024-08-06","2023-09-16","2022-08-09","2022-08-09","2022-08-17","2022-08-04","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":[["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","VAXNEUVANCE","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","ONETOUCH ULTRA2","","","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":""}]}]}