{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Donna J Doody","gend":1,"currentgend":"","add":"4 DOOLIN DR","city":"VEAZIE","state":"ME","zip":"04401","dob":"1957-08-29","age":"","mstatus":"","insh":"10000099030","cliId":"","pno":2072172964,"cno":2073077163,"email":"ddoody2964@gmail.com","ename":"","eno":"","pphy":"TAGUE, COURTNEY","ppno":2078664399,"pcpadd":"EMMC Orono Family Medicine,84 Kelley Rd","pcpcity":"Orono","pcpstate":"ME","pcpzip":"04473","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE BREWER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"4 DOOLIN DR","madd2":"","madd3":"","mcity":"VEAZIE","mstate":"ME","mzip":"04401","pcpfaxno":2078664538,"pcpnpi":1679953194,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4GU6FJ2JT68","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M19042","L4050","L409","R7401","R252","G4733","Z87891","K2100","K317","K319","Z1211","M1711","Z1231","Z79899","M25561","L400","M5432","K8020","N281","K5730","M51369","M47816","M4316","R1084","R109","H401122","H40022","R1032","M5416","N390","B9620","R6889","E039","Z0000","E785","Z0101","I080","Z1212","Z86010","R0609","R059","Z7982","I10","R739","L304","R0600","I350","R748","M7989","C8590","J45909","R0981","F418","E6601","Z6833","M461","Z79891","Z6841","M79645","M85852","M549","Z23","M170","M5459","M5440","Z0001","K760","R160","R945","D225","L821","L814","L309","R1031","J432","L820","D2239","Z7951","U071"],"date":["2023-04-04","2025-03-26","2025-03-24","2024-06-04","2024-06-04","2025-02-05","2025-03-26","2024-03-07","2024-03-07","2024-03-07","2024-03-07","2025-05-01","2025-09-04","2025-07-09","2024-12-30","2025-07-09","2024-10-01","2024-10-01","2024-10-01","2024-10-01","2024-12-05","2024-12-05","2024-12-05","2024-10-01","2024-09-28","2025-08-07","2025-08-07","2024-10-01","2024-09-28","2024-09-28","2024-09-28","2023-08-17","2025-03-26","2023-11-07","2024-11-22","2024-12-09","2022-12-20","2024-03-07","2024-03-07","2023-06-19","2023-11-20","2023-11-20","2024-11-22","2024-11-22","2023-08-08","2023-05-23","2023-05-23","2024-03-11","2023-07-03","2023-07-05","2025-06-02","2025-06-02","2023-11-07","2024-11-19","2023-11-07","2024-12-20","2024-12-20","2024-03-27","2023-04-04","2024-04-03","2024-10-22","2024-10-22","2025-05-01","2024-10-16","2024-10-04","2022-11-03","2024-05-13","2024-05-13","2024-05-13","2024-07-18","2024-07-18","2024-07-18","2024-07-18","2024-10-06","2025-08-11","2025-01-08","2025-01-08","2024-01-11","2022-09-09"],"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":[["","","OXYCODONE HCL","","","Select","Select",""],["","","LATANOPROST","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","SPIRIVA HANDIHALER","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","HYDROMORPHONE HCL","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","BRIMONIDINE TARTRATE","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","OTEZLA","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","TIOTROPIUM BROMIDE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","CLOTRIMAZOLE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","RASUVO","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","SKYRIZI PEN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","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":""}]}]}