{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lisa M Grindle","gend":1,"currentgend":"","add":"16 WILLOW WAY","city":"BREWER","state":"ME","zip":"04412","dob":"1959-11-13","age":"","mstatus":"","insh":"10000118143","cliId":"","pno":2073568345,"cno":"","email":"lisamgrindle@gmail.com","ename":"","eno":"","pphy":"HATCH CLEIN, ANNETTE M","ppno":2079890550,"pcpadd":"43 WHITING HILL RD STE 300,","pcpcity":"BREWER","pcpstate":"ME","pcpzip":"44121006","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":1336189109,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8MM2PJ6VF82","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D225","L814","L821","L570","L565","Z0001","I10","E039","Z23","D122","Z0100","Z1231","Z0189","K626","G2581"],"date":["2025-06-17","2025-06-17","2025-06-17","2025-08-07","2024-12-17","2025-10-15","2025-10-15","2025-10-15","2025-10-15","2025-01-24","2025-06-23","2025-07-28","2025-07-11","2025-01-24","2025-07-11"],"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":[["","","PRAMIPEXOLE DIHYDROCHLORIDE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","ACYCLOVIR","","","Select","Select",""],["","","TRIAMTERENE-HYDROCHLOROTHIAZID","","","Select","Select",""],["","","NYAMYC","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","METAXALONE","","","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":""}]}]}