{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda L Griffin","gend":1,"currentgend":"","add":"175 KNOWLTON CORNER RD","city":"Farmington","state":"ME","zip":"04938","dob":"1952-04-23","age":"","mstatus":"","insh":"10000096112","cliId":"","pno":2073490574,"cno":"","email":"","ename":"","eno":"","pphy":"DUROSE, GALEN G","ppno":2076955267,"pcpadd":"819 N 1ST ST,","pcpcity":"DENNISON","pcpstate":"OH","pcpzip":"44621100","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE GREENVILLE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"13 TALPEY RD","madd2":"","madd3":"","mcity":"Moose River","mstate":"ME","mzip":"04945","pcpfaxno":2076955234,"pcpnpi":1528059409,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9T25WW9DG96","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R55","I351","R509","I10","R6889","R42","R519","R269","R4189","I110","I5033","J9601","N390","I129","R0602","N1330","N134","Z5189","B351","I739","M79671","M79672","R4182","L570","I70213","I6523","I771","F17200","G44229","J449","I701","N179","U071","I1310","R29818","R0789","I6521","N182","Z87891","R809","I509","J189","M62838","M542","M9900","M9901","M9902","M9903","Z5181","J441","M9904","M546","M549","I6529","Z7982","M9908","R058","H40013","H16223","H43393","H04123","H2513","H527","Z0000","R4181","F32A","E278","I951","Z1283","I214","E871","R7401","J811","R918","R0989","I517","G319","R059","R778","E876","F1010","I959","Z7689","R296","G9389"],"date":["2024-03-22","2024-06-06","2024-02-29","2025-05-15","2023-06-05","2024-03-16","2023-06-12","2023-06-12","2023-06-12","2025-01-06","2022-11-29","2022-11-29","2025-10-03","2025-05-01","2024-03-01","2024-03-01","2024-03-01","2022-12-05","2025-08-13","2025-08-13","2025-08-13","2025-08-13","2024-06-19","2025-01-30","2023-03-13","2024-03-17","2023-03-13","2025-01-30","2023-07-19","2025-10-22","2024-06-19","2024-03-12","2024-06-21","2024-11-26","2024-06-19","2024-06-19","2024-06-19","2025-05-01","2025-05-01","2025-05-01","2022-11-26","2022-11-26","2023-07-19","2023-07-19","2023-07-19","2023-07-19","2023-07-19","2023-06-21","2023-07-28","2024-04-25","2023-04-12","2023-07-19","2023-06-21","2023-03-13","2023-03-13","2023-07-19","2024-04-25","2023-06-05","2023-06-05","2023-06-05","2023-06-05","2023-06-05","2023-06-05","2024-01-19","2023-01-17","2025-06-20","2025-05-15","2024-02-29","2023-12-21","2022-11-23","2022-11-23","2022-11-23","2022-11-21","2022-11-24","2022-11-21","2022-11-21","2022-11-19","2022-11-19","2022-11-20","2022-11-20","2022-11-20","2022-11-19","2022-09-27","2022-08-22","2022-08-22"],"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":[["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","HYDRALAZINE HCL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","NORTRIPTYLINE HCL","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE ER","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","SPIKEVAX 2025-2026 (12Y UP)","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","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":""}]}]}