{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James C Rohman","gend":0,"currentgend":"","add":"115 EVERGREEN DR","city":"Waterville","state":"ME","zip":"04901","dob":"1947-12-04","age":"","mstatus":"","insh":"10000020240","cliId":"","pno":2073136930,"cno":"","email":"Trailhead47@gmail.com","ename":"","eno":"","pphy":"PRESTON, DAVID G","ppno":2078731098,"pcpadd":"Mid Maine Medicine,325B Kennedy Memorial Dr","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"THAYER INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"115 EVERGREEN DR","madd2":"","madd3":"","mcity":"Waterville","mstate":"ME","mzip":"04901","pcpfaxno":2078735461,"pcpnpi":1871559203,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8AF6JH5YP83","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I4510","I350","Z953","I70203","N400","Z79899","Z9079","L821","R7309","R9720","I10","I340","L98499","D179","R059","Z87448","R634","Z0000","E7800","M25551","M5450","M1611","M47816","S90561A","W57XXXA","Z634","Z0101","L603","C44219","C44319","I6523","E782","I2510","Z635","R002","E785","H269","H9193","L814"],"date":["2025-07-01","2024-07-01","2023-03-29","2024-03-15","2024-12-03","2023-12-01","2023-12-01","2024-08-28","2024-06-21","2024-12-03","2025-06-27","2025-07-29","2023-12-11","2023-12-11","2023-12-11","2024-12-03","2024-03-26","2025-06-27","2025-06-27","2023-09-22","2023-09-22","2023-09-22","2023-09-22","2025-05-30","2025-05-30","2025-05-30","2023-07-03","2023-06-13","2024-04-10","2024-02-09","2025-10-01","2024-07-01","2024-07-01","2025-02-03","2023-06-05","2024-10-11","2024-10-11","2024-10-11","2024-01-12"],"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":[["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","FINASTERIDE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","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":""}]}]}