{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael W Lindblom","gend":0,"currentgend":"","add":"34 NICOLE LN","city":"Benton","state":"ME","zip":"04901","dob":"1953-06-04","age":"","mstatus":"","insh":"10000060450","cliId":"","pno":"2076492059","cno":"2076492059","email":"mlindblom35@gmail.com","ename":"","eno":"","pphy":"HANNON, GAVIN","ppno":"","pcpadd":"Northern Light Health Center Unity,80 Main St","pcpcity":"Unity","pcpstate":"ME","pcpzip":"04988","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT HEALTH CENTER UNITY","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"34 NICOLE LN","madd2":"","madd3":"","mcity":"Benton","mstate":"ME","mzip":"04901","pcpfaxno":"8606454151","pcpnpi":"1992327696","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6WU4D79GY73","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L820","D23121","E119","N2581","E1142","Z0001","E11319","E1122","N184","I2510","D649","L84","K862","I129","Z794","J90","J9811","I5030","E113212","E113211","E1165","Z7984","Z978","I130","E1140","I10","E785","K6389","K5732","R809","K5792","L42","E113213","B351","R262","E1152","R2681","R531","M726","M86172","E11621","Z4781","Z89422","I739","L97522","I96","Z4800","I110","L97523","Z89432","Z7982","Z79899","T8131XA","E1169","S91105A","M869","Z022","E1151","L97529","S91105D","L97528","Z48817","Z89429","E113412","I70262","T8131XD","S91302D","X58XXXD","E13622","I1310","L97509","H02051","L03116","M5450","D487"],"date":["2023-04-10","2023-04-10","2025-09-02","2023-11-15","2025-02-26","2024-05-23","2023-04-27","2025-06-03","2025-06-03","2024-10-04","2024-04-16","2024-02-07","2023-05-02","2025-06-03","2025-09-02","2023-05-02","2025-09-03","2024-12-17","2024-07-11","2026-01-29","2026-02-17","2023-05-11","2023-05-11","2024-07-25","2023-08-10","2025-04-03","2025-04-03","2023-12-08","2023-12-08","2023-11-17","2023-12-08","2024-03-21","2024-02-22","2024-10-08","2024-02-07","2025-05-29","2025-09-23","2025-09-23","2025-09-23","2025-09-23","2025-08-21","2026-01-10","2025-10-23","2025-10-12","2025-04-02","2025-08-14","2026-02-12","2025-07-17","2025-08-21","2025-09-25","2026-02-12","2026-02-12","2025-08-11","2025-08-21","2025-05-20","2025-09-22","2025-08-29","2025-11-11","2026-01-08","2025-01-03","2025-08-21","2025-06-11","2025-06-11","2026-01-29","2025-04-17","2025-03-05","2025-11-26","2025-11-26","2025-03-12","2026-01-12","2025-03-27","2025-02-27","2025-02-26","2025-03-27","2023-03-01"],"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":[["","","DICLOXACILLIN","500 MG","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","BUMETANIDE","2 MG","","Select","Select",""],["","","FLUTICASONE PROP","50 MCG","","Select","Select",""],["","","Bd Nano 2 Gen","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE","30 MG","","Select","Select",""],["","","AMLODIPINE","2.5 MG","","Select","Select",""],["","","TRESIBA FLEXTOUCH","","","Select","Select",""],["","","FIASP FLEXTOUCH","","","Select","Select",""],["","","SIMVASTATIN","40 MG","","Select","Select",""],["","","METOPROLOL SUCC","100 MG","","Select","Select",""],["","","CLOPIDOGREL","75 MG","","Select","Select",""],["","","UNIFIN PENTIPS","","","Select","Select",""],["","","NITROGLYCERIN","0.4 MG","","Select","Select",""],["","","GLIPIZIDE","10 MG","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","CALCITRIOL","0.5 MCG","","Select","Select",""],["","","Ceftriaxone Pf","2 GM","","Select","Select",""],["","","AMOXICILLIN\/CLAV","500\/125 MG","","Select","Select",""],["","","ALLOPURINOL","100 MG","","Select","Select",""],["","","Lantus Solostar","","","Select","Select",""],["","","METRONIDAZOLE","500 MG","","Select","Select",""],["","","Sodium Cl Pf 0.9 % Inj Braun","","","Select","Select",""],["","","CEFTRIAXONE","","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","50 MG","","Select","Select",""],["","","HYDROXYZINE HCL","25 MG","","Select","Select",""],["","","NOVOLOG","","","Select","Select",""],["","","LEVOFLOXACIN","750 MG","","Select","Select",""],["","","ACYCLOVIR","400 MG","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","Freestyle Libre 2 Sensor","","","Select","Select",""],["","","LEVEMIR FLEXPEN","","","Select","Select",""],["","","BD NANO","","","Select","Select",""],["","","SODIUM CL PF","0.009","","Select","Select",""],["","","FREESTYLE LIBRE","","","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":""}]}]}