{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Judy S Harriman","gend":1,"currentgend":"","add":"58 COLONIAL CIR APT 320","city":"Brewer","state":"ME","zip":"04412","dob":"1942-04-07","age":"","mstatus":"","insh":"00008054900","cliId":"","pno":5083973208,"cno":"","email":"Declined@010826.com","ename":"","eno":"","pphy":"ARORA, MANPREET K","ppno":"2079476141","pcpadd":"Northern Light Internal Medicine,302 Husson Ave Ste 1","pcpcity":"Bangor","pcpstate":"ME","pcpzip":"04401","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"2078253864","add2":"","add3":"","madd1":"58 COLONIAL CIR APT 320","madd2":"","madd3":"","mcity":"BREWER","mstate":"ME","mzip":"04412","pcpfaxno":"2079476720","pcpnpi":"1215433057","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6EM5HT1UG92","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R441","R9089","Z8616","Z0000","Z87891","R443","E039","D61818","Z20822","J209","L570","L820","R208","L538","L298","E611","R290","H903","S91332A","Z23","W208XXA","Y92007","D509","G4730","R109","M25561","M160","M5136","M48061","Z96651","J4540","J849","R0602","G2581","G4739","R202","R200","M62838","M79601","D0512","Z79811","Z923","D485","L218","L814","D225","C44529","G4731","G4733","Z1231","L03032","C50912","Z170","R0981","R350","R051","N390","M899","M8589","N179","Z13820","L821","I6782","D1801","L728","I340","I517","S81801A","M159","Z01810","Z471","G5603","L309","C44722","Z08","Z85828","Z98890","J320","H0012","D649","L738","Z0100","B078","T8140XA","L929","C50412","I872","B079","L280","N907","H538","I10","I38","Z1211","D124","K5730","K648","C44329","H539","Z48817","Z1389","J341","J3489","R059","J040","J322","M85852","Z86010","D122","D123","Z7689","M48062","Z853","J4520","L918","L708","D539","T881XXD"],"date":["2023-04-28","2023-04-05","2023-04-05","2025-06-27","2025-11-05","2024-04-16","2025-06-05","2025-07-08","2024-09-04","2023-06-18","2025-09-03","2025-06-24","2023-11-01","2024-05-21","2023-11-01","2023-07-31","2023-07-31","2023-08-01","2023-08-07","2023-08-07","2023-08-07","2023-08-07","2023-08-28","2023-07-25","2023-09-19","2023-11-06","2023-09-19","2023-09-19","2023-09-19","2024-11-18","2025-06-03","2025-06-03","2025-06-03","2024-06-03","2025-05-23","2023-10-24","2023-10-24","2023-10-24","2023-10-24","2024-09-05","2024-12-17","2024-12-17","2026-01-12","2023-11-01","2026-03-03","2025-09-03","2023-12-21","2024-12-01","2025-10-11","2025-01-15","2024-01-09","2024-12-17","2024-12-17","2024-03-25","2024-03-18","2024-03-25","2024-03-18","2024-04-16","2024-06-05","2024-05-21","2025-06-10","2026-03-03","2023-03-24","2026-03-03","2026-03-03","2025-06-30","2025-06-30","2025-07-15","2024-08-27","2025-06-16","2024-11-18","2024-12-31","2025-12-02","2025-12-02","2025-12-09","2025-12-09","2025-12-09","2025-09-19","2024-10-21","2025-06-27","2024-12-04","2025-10-06","2025-04-08","2025-04-08","2025-08-14","2025-01-21","2025-06-24","2025-09-03","2025-09-03","2025-12-05","2025-11-05","2025-02-20","2025-02-18","2024-08-05","2024-08-05","2024-08-05","2024-08-05","2026-01-12","2025-11-05","2025-12-09","2026-03-09","2025-10-11","2025-10-11","2024-09-04","2025-11-05","2025-10-11","2025-06-10","2023-02-27","2023-02-27","2023-02-27","2023-03-16","2023-03-14","2023-03-16","2023-03-16","2023-03-16","2023-03-16","2023-03-16","2023-02-08"],"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":[["","","Mupirocin 2 % Ointment Teva","","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Ointment Padagis","","","Select","Select",""],["","","Fluocinonide 0.05 % Top Sol Zydus","","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","Ketoconazole 2 % Shampoo Viona Pharmaceuti","","","Select","Select",""],["","","ANASTROZOLE","1 MG","","Select","Select",""],["","","MNEXSPIKE","","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","FLUZONE HIGH-DOSE","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","Ketoconazole 2 % Shampoo Tolmar","","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","LEVOTHYROXINE","75 MCG","","Select","Select",""],["","","LETROZOLE","2.5 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","DULOXETINE","60 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","CEFADROXIL","500 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","BREO ELLIPTA","","","Select","Select",""],["","","Fluzone High-Dose Quad 2023-24","","","Select","Select",""],["","","BUDESONIDE\/FORMOTEROL","160\/4.5 MCG","","Select","Select",""],["","","GABAPENTIN","100 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","FAMOTIDINE","40 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Ascend Labs","","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","BREYNA","","","Select","Select",""],["","","Ketoconazole 2 % Shampoo Padagis","","","Select","Select",""],["","","Fluorouracil 5 % Cream Taro","","","Select","Select",""],["","","OLANZAPINE","2.5 MG","","Select","Select",""],["","","FLUOCINONIDE","0.0005","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD","","","Select","Select",""],["","","KETOCONAZOLE","0.02","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.001","","Select","Select",""],["","","MUPIROCIN","0.02","","Select","Select",""],["","","FLUOROURACIL","0.05","","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":""}]}]}