{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lorraine M Turner","gend":1,"currentgend":"","add":"137 PARK ST","city":"DOVER FOXCROFT","state":"ME","zip":"04426","dob":"1942-02-08","age":"","mstatus":"","insh":"10000116423","cliId":"","pno":2075400269,"cno":"","email":"geoundy@yahoo.com","ename":"","eno":"","pphy":"HARTT, KRISTIN M","ppno":2078346140,"pcpadd":"194 E MAIN ST,FORT KENT","pcpcity":"FORT KENT","pcpstate":"ME","pcpzip":"47431428","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT WOMENS HEALTH","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"151 WILLIMANTIC RD","madd2":"","madd3":"","mcity":"MONSON","mstate":"ME","mzip":"04464","pcpfaxno":2078342949,"pcpnpi":1275587131,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2VW1YU8KM25","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S59202A","S52592A","E1129","M150","F0390","G250","S5292XA","N184","D6489","S0003XA","M25561","W19XXXA","M5459","R2681","S5292XD","S62102A","Z8781","W010XXA","E119","K5909","M810","Z0101","H5203","H52223","H524","S59202D","S0083XA","S6292XA","E1165","S52502A","E875","S6992XA"],"date":["2025-03-25","2025-03-04","2025-01-08","2025-01-08","2025-01-08","2025-08-12","2025-03-25","2024-10-24","2024-10-24","2025-07-04","2025-07-04","2025-07-04","2024-09-17","2024-09-17","2025-04-17","2025-03-04","2025-03-04","2025-03-04","2025-08-12","2025-08-12","2025-08-12","2024-12-09","2024-12-09","2024-12-09","2024-12-09","2025-05-20","2025-07-04","2025-03-04","2025-07-15","2025-03-04","2024-08-19","2025-03-04"],"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":[["","","DIVALPROEX SODIUM","","","Select","Select",""],["","","DEXCOM G7 RECEIVER","","","Select","Select",""],["","","BASAGLAR KWIKPEN U-100","","","Select","Select",""],["","","DEXCOM G7 SENSOR","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","AUTOSHIELD DUO PEN NEEDLE","","","Select","Select",""],["","","PRIMIDONE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","SOLIFENACIN SUCCINATE","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","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":{"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":""}]}]}