{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barry A Norling","gend":0,"currentgend":"","add":"535 BEECH HILL RD","city":"NORRIDGEWOCK","state":"ME","zip":"04957","dob":"1945-05-17","age":"","mstatus":"","insh":"10000085856","cliId":"","pno":"2076121413","cno":"","email":"","ename":"","eno":"","pphy":"PROKOP, OTO","ppno":"2074740905","pcpadd":"REDINGTON MED PRIMARY CA,46 FAIRVIEW AVE STE 111","pcpcity":"SKOWHEGAN","pcpstate":"ME","pcpzip":"04976","pcpcounty":"","pcpid":"","pcpname":"REDINGTON MEDICAL PRIMARY CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"535 BEECH HILL RD","madd2":"","madd3":"","mcity":"NORRIDGEWOCK","mstate":"ME","mzip":"04957","pcpfaxno":"2074746930","pcpnpi":"1083631014","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6V13VC1XG15","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I8290","C73","J029","E890","Z9089","J9811","M5430","Z510","M47816","N1830","Z0000","Z86718","Z7901","R0789","Z13820","I743","M7750","R490","I723","Z08","Z0101","I7140","I771","Z95828","M25562","Z85850","Z8679","Z01812","Z5181","M533","M109","I748","S1086XA","M25552","M4186"],"date":["2023-12-27","2026-01-12","2023-04-21","2025-08-05","2023-06-20","2023-06-20","2023-09-05","2023-09-01","2023-07-18","2025-10-03","2025-10-06","2025-11-14","2023-11-17","2024-03-22","2024-04-05","2026-02-26","2025-12-09","2025-05-02","2025-09-04","2024-10-23","2025-05-12","2025-05-08","2025-05-08","2025-05-08","2024-07-30","2025-04-25","2025-09-25","2025-05-08","2024-07-16","2025-06-06","2025-08-21","2025-05-23","2025-10-15","2023-02-14","2023-02-14"],"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":[["","","AMOXICILLIN\/CLAV","500\/125 MG","","Select","Select",""],["","","JANTOVEN","","","Select","Select",""],["","","WARFARIN","2 MG","","Select","Select",""],["","","FLUOXETINE","40 MG","","Select","Select",""],["","","COLCHICINE","0.6 MG","","Select","Select",""],["","","ATORVASTATIN","40 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","Duloxetine","60 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","PAXLOVID","300\/100 MG","","Select","Select",""],["","","LEVOTHYROXINE","300 MCG","","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":""}]}]}