{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ronald A Trundy","gend":0,"currentgend":"","add":"61 ICE HOUSE RD.","city":"STONINGTON","state":"ME","zip":"04681","dob":"1957-03-04","age":"","mstatus":"","insh":"10000095485","cliId":"","pno":"2074790292","cno":"","email":"","ename":"","eno":"","pphy":"COBB, TIMOTHY A","ppno":"2073672311","pcpadd":"Northern Light Primary Care Stonington,354 Airport Rd","pcpcity":"Stonington","pcpstate":"ME","pcpzip":"04681","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE STONINGTON","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"61 ICE HOUSE RD.","madd2":"","madd3":"","mcity":"STONINGTON","mstate":"ME","mzip":"04681","pcpfaxno":"2073672805","pcpnpi":"1326557372","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8H98A73YN40","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R0602","R0600","I7140","D229","Z0101","B078","I10","F411","G4733","H35073","H04123","Z961","Z0000","R5383","Z23","M48061","M5116","M4726","R7989","Z87891","Z122","E291","J432","J8410","R911","J439"],"date":["2023-04-03","2023-04-03","2024-04-26","2023-05-16","2024-06-18","2023-05-16","2023-09-21","2023-08-15","2024-06-20","2024-03-25","2023-09-21","2023-09-21","2023-10-09","2023-10-10","2023-10-18","2023-10-25","2023-10-25","2023-10-25","2024-04-10","2023-11-16","2023-11-16","2023-12-18","2024-03-08","2024-03-08","2024-03-08","2024-06-11"],"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":[["","","Nystop","","","Select","Select",""],["","","Testosterone 1.62%","20.25 MG","","Select","Select",""],["","","Lorazepam","1 MG","","Select","Select",""],["","","Fluticasone Prop","50 MCG","","Select","Select",""],["","","Rosuvastatin","20 MG","","Select","Select",""],["","","Triamcinolone Acet 0.025 % Cream Macleods","","","Select","Select",""],["","","Buspirone","5 MG","","Select","Select",""],["","","Losartan\/Hydrochlorothiazide","50\/12.5 MG","","Select","Select",""],["","","Pantoprazole","40 MG","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Amlodipine","5 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Clotrimazole 1 % Cream Taro","","","Select","Select",""],["","","Triamcinolone Acet 0.025 % Cream Padagis","","","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":""}]}]}