{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Gerald A Merriman","gend":0,"currentgend":"","add":"199 SEVENTH ST","city":"Auburn","state":"ME","zip":"04210","dob":"1941-08-04","age":84,"mstatus":"Married","insh":"10000008884","cliId":"","pno":2077863278,"cno":2077541643,"email":"declined@11052025.com","ename":"Christine Merriman","eno":"2077863278","pphy":"FAGONE, RENEE S","ppno":2077955700,"pcpadd":"12 HIGH ST,SUITE 400","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42407676","pcpcounty":"","pcpid":"","pcpname":"CENTRAL MAINE INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2077863278,"add2":"","add3":"","madd1":"199 SEVENTH ST","madd2":"","madd3":"","mcity":"Auburn","mstate":"ME","mzip":"04210","pcpfaxno":2077955727,"pcpnpi":1164653879,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2H54W49XW91","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R197","Z48815","R531","R4182","K8050","K269","I10","E785","I2510","R109","R1084","R1013","K5900","E119","G3184","R0602","R059","L8992","R5383","L258","D509","F0390","M549","M4800","Z79899","K8051","L853","R400","R9720","L299","R6889","L89159","G8929","J189","R051","R233","R7989","L8990","R748","R413","J1289","R5381","K922","R945","K8041","K2211","K260","D62","R410","B351","M79675","M79674","E1159","R079","M79652","M79651","L290","M5450","K760","K2090","R262","L89150","N390","R10A2","Z0000","I209","E1140","F419","Z8719","L89309","F1990","G4700","E1165","K7460","E876","R1111","K219","G894","R10819","R110","M48061","N179","K769","R062","M19041","L89323","L89152","K2210","Z0389","K267","L281","K5903","M79644","E871","M7989","E233"],"date":["2025-06-29","2024-10-26","2025-10-01","2025-06-20","2024-12-03","2025-04-24","2025-10-06","2025-04-24","2025-07-29","2024-10-01","2025-07-29","2024-10-29","2025-10-17","2025-10-06","2024-09-30","2025-06-21","2025-06-21","2024-12-03","2025-06-09","2025-06-09","2025-06-12","2025-04-24","2025-10-30","2025-03-20","2025-10-21","2024-10-02","2023-10-18","2024-11-15","2023-06-09","2025-10-30","2024-08-28","2024-09-18","2025-10-06","2025-07-30","2025-06-20","2025-08-06","2024-05-17","2025-10-30","2023-10-13","2024-07-10","2025-07-25","2024-10-10","2024-10-02","2024-09-28","2024-10-02","2024-10-02","2024-10-02","2024-10-02","2024-11-20","2025-09-23","2025-09-23","2025-09-23","2025-09-23","2024-11-24","2024-09-18","2024-09-18","2024-10-29","2025-10-06","2023-09-19","2023-09-19","2023-12-07","2024-11-25","2025-10-06","2025-10-06","2025-02-20","2023-03-22","2024-10-21","2023-09-01","2023-06-20","2024-09-20","2024-09-20","2023-04-19","2025-07-30","2025-07-30","2025-11-15","2024-09-27","2025-06-23","2025-06-23","2025-11-11","2025-06-20","2025-03-29","2025-11-11","2023-06-16","2025-10-01","2024-07-29","2024-10-02","2024-10-02","2024-10-02","2024-10-03","2024-12-03","2025-10-21","2022-11-07","2022-09-26","2022-08-15","2022-09-07","2022-08-15"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Self-Assessment and Social History (SDOH)","q":[{"a":{"indx":["","","","","1"],"comment":["","","","",""],"sub":[]}},{"a":{"indx":["1","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"score":[0,0,0,0]}},{"a":{"indx":["","1","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"arr":["Retired"],"comment":[]},{"a":{"indx":["","","1"],"comment":["","",""],"score":[0,0,0,0]}},{"a":{"indx":["","1",""],"comment":["","",""],"score":[0,0,0,0],"sub":{"indx":[["1",""],["","1"]],"comment":[["",""],["",""]],"sub":[]}}},{"a":[]},{"a":[{"indx":["1",""],"comment":["",""],"sub":[]}]},{"a":{"indx":["","1",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","","1"],"comment":["","",""],"sub":[]}},{"a":{"indx":["","1",""],"comment":["","",""],"sub":[]}},{"a":[]},{"a":{"indx":["","","1"],"comment":["","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[["","",""],["","",""],["","",""],["","",""],["","",""],["","",""]]}]},{"t":"Medical History","q":[{"a":{"indx":["1"],"comment":[],"sub":{"indx":[],"comment":[""],"sub":[]}}},{"index":1,"comment":"","sub":[]},{"a":[{"indx":["","","","1","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","1","","",""],"comment":["","","","","",""],"sub":{"indx":[["back problems"],["1","",""]],"comment":[[""],["","",""]],"sub":{"indx":[[],[[]]],"comment":[[],[[]]],"sub":[]}}},{"indx":["","1","","","",""],"comment":["","","","","",""],"sub":{"indx":[["back problems "]],"comment":[[""]],"sub":[]}},{"indx":["1","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["1","","","","",""],"comment":["","","","","",""],"sub":[]}]},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["can't remember"]],"comment":[[""]],"sub":[]}}},{"a":{"indx":["","","","","1","","","","","","","",""],"comment":["","","","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","","","","","1"],"comment":["","","","","","","",""],"sub":[]}}]},{"t":"Family History","q":[{"index":-1,"comment":"","sub":[]}]},{"t":"Preventive Care","q":[{"a":[["",""],["",""],["",""],["",""],[true,""],["",""],["",""],["",""],["",""],[true,""],["",""],["",""],["",""],["",""],{"comment":""}]},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"t":"Allergies \/ Medications","q":[{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"comment":"","sub":[["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","CHOLESTYRAMINE","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","DUPIXENT PEN","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","FARXIGA","","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","DONEPEZIL HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","GAVILYTE-N","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","DAPAGLIFLOZIN","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","FREESTYLE FREEDOM LITE","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","ALFUZOSIN HCL ER","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","CHOLESTYRAMINE LIGHT","","","Select","Select",""],["","","LINZESS","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","PREVALITE","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","TRULANCE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FREESTYLE LITE TEST STRIP","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""]]}},{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[],"textValue":""}}},{"a":[{"indx":["1",""],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]},{"indx":["1",""],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]},{"indx":["","1"],"comment":["",""],"sub":[]}]},{"a":[]},{"a":[]}]},{"t":"Assessment of Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}],"phq":[{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"subGroup":[{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","","","",""],"comment":["","","","","","",""]},{"indx":["","","","","",false],"comment":[""]}]}]}},{"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":{"indx":[],"comment":[],"sub":[]}}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":{"indx":["1","","","",""],"comment":["","","","",""],"score":[0,0,0,0]}},{"a":[]},{"a":[""]},{"a":[]},{"a":[]},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":[]},{"a":[""]},{"arr":[],"comment":[]},{"a":{"indx":["","","","","","","","","","",""],"comment":["","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"2025-10-01T11:30","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"In Person","a10":[],"a11":"","a12":"","a13":"","a15":[],"a14":"","a16":"","a18":"","a19":"true","a20":"","a21":""}]}]}