{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sharon A Crosby","gend":1,"currentgend":"","add":"8 LINCOLN DR","city":"NEWPORT","state":"ME","zip":"04953","dob":"1945-09-13","age":"","mstatus":"","insh":"10000027498","cliId":"","pno":"2073550035","cno":"","email":"sharon.ann.crosby@gmail.com","ename":"","eno":"","pphy":"BADEEN, STEVEN J","ppno":"2073684292","pcpadd":"100 Main St,","pcpcity":"Newport","pcpstate":"ME","pcpzip":"04953","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE NEWPORT","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"8 LINCOLN DR","madd2":"","madd3":"","mcity":"NEWPORT","mstate":"ME","mzip":"04953","pcpfaxno":"","pcpnpi":"1801984471","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1D66WA0YC65","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N390","R7401","R350","C3490","I6523","M50322","M5134","E278","J479","Z08","J189","M19042","Z0100","H04123","R0602","Z0000","J90","J431","C3491","M79642","M79641","M19041","E559","M25532","M25531","Z87891","J700","Z923","R0609","Z0001","Z1231","J449","Z85118","J701","L2089","Z79899","Z0101","H5203","M4316","C3411","D225","L821","L814","L608","C770","E039","Z122","Z9221","J8410","R590","M549"],"date":["2023-04-11","2023-07-12","2023-05-25","2025-10-08","2023-06-26","2023-06-26","2023-06-26","2023-06-26","2023-06-26","2025-11-06","2024-04-23","2023-12-28","2024-08-01","2023-07-27","2024-12-12","2025-12-16","2023-12-12","2024-12-12","2025-12-18","2024-02-14","2024-02-14","2023-12-28","2023-12-28","2024-02-14","2024-02-14","2025-10-17","2023-03-30","2025-10-17","2023-03-30","2024-12-09","2026-01-08","2025-12-18","2025-12-18","2025-12-18","2024-08-02","2024-08-02","2025-08-05","2025-08-05","2025-10-22","2025-04-21","2025-08-08","2025-08-08","2025-08-08","2025-08-08","2024-11-06","2025-06-04","2025-04-07","2023-03-29","2023-03-29","2023-03-29","2026-01-12"],"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":[["","","CELECOXIB","100 MG","","Select","Select",""],["","","OMEPRAZOLE","10 MG","","Select","Select",""],["","","FLUTICASONE PROP","50 MCG","","Select","Select",""],["","","ATORVASTATIN","10 MG","","Select","Select",""],["","","FLUZONE HIGH-DOSE","","","Select","Select",""],["","","ALENDRONATE","70 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","LEVOTHYROXINE","25 MCG","","Select","Select",""],["","","Tacrolimus 0.1 % Ointment Encube","","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","Anoro Ellipta","","","Select","Select",""],["","","Fluad Quad 2023-2024","","","Select","Select",""],["","","Tacrolimus 0.1 % Ointment Accord","","","Select","Select",""],["","","Hydrocortisone 2.5 % Cream Fougera","","","Select","Select",""],["","","ABRYSVO W\/ DILUENT SYRINGE","","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","TACROLIMUS","0.001","","Select","Select",""],["","","FLUAD QUAD","","","Select","Select",""],["","","HYDROCORTISONE","0.025","","Select","Select",""],["","","COMIRNATY","","","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":""}]}]}