{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James F Grindle","gend":0,"currentgend":"","add":"16 WILLOW WAY","city":"BREWER","state":"ME","zip":"04412","dob":"1957-02-26","age":"","mstatus":"","insh":"10000102685","cliId":"","pno":2073567235,"cno":"","email":"grinny257@icloud.com","ename":"","eno":"","pphy":"KNIPSCHER, KATHLEEN A","ppno":2079890550,"pcpadd":"Eastern Maine Medical Center,43 Whiting Hill Rd","pcpcity":"Brewer","pcpstate":"ME","pcpzip":"04412","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE BREWER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"16 WILLOW WAY","madd2":"","madd3":"","mcity":"BREWER","mstate":"ME","mzip":"04412","pcpfaxno":2079890551,"pcpnpi":1376071894,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5WH6MJ6PF49","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M2653","R293","M6289","H6122","G4733","K7400","K760","K589","E119","H43813","K7460","Z1289","K7689","I10","E785","Z9989","Z122","Z87891","Z6841","Z7985","Z789","Z0000","R748","Z8719","L570","D485","D225","L821","L814","Z7189","K2100","D123","Z0389","N400","Z1211","Z1212","D125","D2371","F17211","K2270","M79642","E1140","L918","R208","B372","F1290","I517","S6992XA","D1801","B078","D294","Z09","Z872"],"date":["2025-04-16","2025-04-16","2025-04-16","2025-03-31","2025-08-21","2024-03-18","2025-01-08","2023-03-22","2025-11-03","2025-11-03","2025-10-30","2025-09-09","2024-06-24","2024-10-03","2023-04-25","2023-04-26","2025-02-04","2025-02-04","2024-10-04","2023-01-24","2023-01-23","2025-10-29","2024-10-03","2024-10-03","2025-04-02","2024-09-10","2024-09-10","2025-04-02","2025-04-02","2024-09-10","2023-02-06","2023-02-06","2023-02-06","2023-01-23","2023-02-06","2023-02-06","2023-02-06","2024-09-10","2024-01-18","2023-10-02","2024-04-08","2025-04-08","2023-08-31","2023-08-31","2023-11-06","2023-11-06","2024-03-20","2024-04-08","2025-04-02","2025-04-02","2024-03-14","2024-03-14","2024-03-14"],"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":[["","","FAMOTIDINE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","CHLORTHALIDONE","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","ACYCLOVIR","","","Select","Select",""],["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","CLOTRIMAZOLE-BETAMETHASONE","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","LOSARTAN-HYDROCHLOROTHIAZIDE","","","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":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"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":""}]}]}