{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lois E Oldenburg","gend":1,"currentgend":"","add":"695 GRAY RD","city":"WINDHAM","state":"ME","zip":"04062","dob":"1943-04-25","age":"","mstatus":"","insh":"10000116731","cliId":"","pno":"2078930152","cno":"","email":"","ename":"","eno":"","pphy":"KIM, REGINA Y","ppno":"2075351340","pcpadd":"MERCY WEST FALMOUTH PRIMARY CARE,75 GRAY RD","pcpcity":"FALMOUTH","pcpstate":"ME","pcpzip":"04105","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT MERCY PRIMARY CARE WEST FALMOUTH","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"695 GRAY RD","madd2":"","madd3":"","mcity":"WINDHAM","mstate":"ME","mzip":"04062","pcpfaxno":"2075351358","pcpnpi":"1104906155","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6UF0WM7WG90","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I509","M86272","S88111S","E8889","I10","I158","E11628","L03116","L02419","L89520","S82001A","M25461","R269","E119","R339","M5450","S91002D","S99912A","S80911A","W19XXXA","D649","N1832","I5021","J449","R4182","L089","N179","N189","E11622","T8789","Z89511","Z466","I2510","E875","E8720","I70245","S81801D","M86172","I083","I5040","Z0000","E785","L89892","G8918","S91002A","I340","Z452","J90","E11621","I4891","E871","S8991XA","Z515","L02416","S82044D","I739","T839XXA","S81802A","X58XXXA","I70213","S91001A","M79605","Z23","I70244","Z7689","R609","M25472","M009","M85861","E1122","S82001D","M79672","N1830","E1142","M79662"],"date":["2025-12-31","2026-01-05","2025-12-18","2025-03-21","2025-07-21","2025-03-21","2026-01-10","2026-01-12","2025-02-07","2024-10-02","2025-01-21","2024-12-16","2025-02-11","2026-03-03","2025-01-13","2025-01-13","2026-02-20","2024-12-16","2024-12-16","2024-12-16","2025-02-17","2025-03-01","2025-02-21","2025-02-04","2025-02-01","2026-02-06","2025-03-11","2025-02-07","2025-12-05","2024-11-11","2024-12-10","2026-01-15","2025-03-14","2025-02-20","2025-02-07","2025-05-21","2024-10-29","2025-03-11","2025-02-05","2025-02-05","2025-07-21","2025-07-21","2024-12-01","2025-02-04","2025-02-04","2025-02-04","2025-02-07","2025-02-07","2025-12-05","2025-09-02","2025-02-12","2024-12-16","2025-02-06","2025-10-17","2025-01-21","2025-10-21","2025-01-13","2025-02-04","2025-02-04","2024-11-20","2025-02-02","2025-02-01","2025-02-23","2025-05-21","2025-04-07","2025-12-05","2025-12-05","2025-02-01","2025-01-21","2025-10-27","2025-01-07","2025-01-31","2024-10-07","2024-10-07","2025-12-05"],"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":[["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","Bd Nano 2 Gen","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","METOPROLOL SUCC","50 MG","","Select","Select",""],["","","CEFTRIAXONE PF","2 GM","","Select","Select",""],["","","CLOPIDOGREL","75 MG","","Select","Select",""],["","","ATORVASTATIN","80 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","INSULIN GLARGINE-YFGN","","","Select","Select",""],["","","NITROGLYCERIN","0.4 MG","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","GABAPENTIN","100 MG","","Select","Select",""],["","","BASAGLAR KWIKPEN","","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","CEFUROXIME","500 MG","","Select","Select",""],["","","Freestyle Libre 2 Sensor","","","Select","Select",""],["","","ACCU-CHEK AVIVA PLUS","","","Select","Select",""],["","","BD NANO","","","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":""}]}]}