{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Cecil L Scott","gend":0,"currentgend":"","add":"63 MERRILL RD","city":"STETSON","state":"ME","zip":"04488","dob":"1957-08-17","age":"","mstatus":"","insh":"10000103201","cliId":"","pno":"2072962242","cno":"","email":"ccv1993@aol.com","ename":"","eno":"","pphy":"BARATTA, ELIZABETH A","ppno":"2079737979","pcpadd":"Northern Light Family Medicine and Residency,895 Union St Ste 12","pcpcity":"Bangor","pcpstate":"ME","pcpzip":"04401","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT HEALTH CENTER NEWPORT PLAZA","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"63 MERRILL RD","madd2":"","madd3":"","mcity":"STETSON","mstate":"ME","mzip":"04488","pcpfaxno":"2079479579","pcpnpi":"1740718261","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5NF1E08XR06","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M5416","Z0000","Z79899","Z122","M25562","Z1211","M47816","M1712","M23204","Z5181","Z0100","I10","J439","R030","Z0101","M4854XA","H40023","S61219A","M25551","R519","J449","Z13820","S61214A","W292XXA","Z7982"],"date":["2025-05-23","2025-09-08","2023-10-10","2025-05-13","2024-04-09","2024-02-05","2024-05-01","2024-07-23","2024-04-23","2024-05-02","2024-05-30","2025-12-10","2026-02-04","2025-03-12","2026-01-09","2025-01-31","2026-01-09","2023-03-29","2025-12-17","2025-03-12","2025-01-03","2025-06-18","2023-03-13","2023-03-13","2023-03-13"],"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":[["","","HYDROMORPHONE HCL","","","Select","Select",""],["","","MORPHINE","60 MG","","Select","Select",""],["","","HYDROMORPHONE","4 MG","","Select","Select",""],["","","Testosterone 1.62%","20.25 MG","","Select","Select",""],["","","HYDROXYZINE PAM","25 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","PREGABALIN","200 MG","","Select","Select",""],["","","MELOXICAM","15 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","BACLOFEN","10 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","TESTOSTERONE","1.62% (20.25","","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":""}]}]}