{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Christine E Lommler","gend":1,"currentgend":"","add":"103 JOHNSON MILL RD","city":"ORRINGTON","state":"ME","zip":"04474","dob":"1949-01-31","age":"","mstatus":"","insh":"10000044639","cliId":"","pno":2078522288,"cno":"","email":"Chris.lommler5@gmail.com","ename":"","eno":"","pphy":"PARADIS, KENDRA M","ppno":"","pcpadd":"C\/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT,PO BOX 7291","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42437291","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"103 JOHNSON MILL RD","madd2":"","madd3":"","mcity":"ORRINGTON","mstate":"ME","mzip":"04474","pcpfaxno":2077774397,"pcpnpi":1588012314,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8KA3MU7RY98","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M0600","Z1211","Z1231","M5416","C50912","Z170","Z1721","Z1732","G2581","M1712","M25462","M1711","D649","Z0101","M810","Z79899","G4733","Z79811","Z923","I77810","E782","Z952","M4726","I252","R928","N6315","M0609","M19041","M19071","M1812","M25562","I422","C50812","M25551","Z791","G629","M461","M7918","Z780","C50811","N6313","M170","M19241","M19242","I340","R200","Z853","M069","H35389","H04123","H43813","Z961","M48061","M5116","M4727","M4316","I081","I2720","M25561","Z0000","Z01810","I083","I493","C50112","E6601","G8929","M0520","N1831","M5431","M5117","G6289","M5417","C50412","D241","H53433","Z13220","M5450","N6489","R5383","M25361","M47816","Z98890","C50919","H9113","Z510","R9431","Z13820","C773","Z803"],"date":["2025-10-09","2025-03-25","2025-07-18","2025-11-20","2025-10-14","2025-10-14","2025-10-14","2025-10-14","2025-10-27","2025-06-30","2023-09-06","2024-09-26","2025-05-15","2024-11-13","2024-11-07","2024-07-18","2025-05-15","2024-10-15","2024-10-15","2025-10-02","2025-09-10","2025-09-09","2025-09-27","2024-03-29","2023-07-14","2023-02-20","2025-07-09","2025-07-03","2025-07-03","2025-07-03","2025-06-05","2024-10-30","2023-05-17","2023-05-17","2023-11-14","2023-11-14","2025-01-16","2025-02-06","2024-11-07","2023-02-20","2023-02-20","2025-07-09","2025-07-09","2025-07-09","2025-09-10","2023-08-17","2024-07-17","2023-02-08","2025-07-17","2025-07-17","2025-07-17","2025-07-17","2025-09-27","2025-09-27","2025-09-27","2025-09-27","2024-10-30","2024-10-30","2024-05-23","2025-10-27","2025-10-02","2025-10-02","2025-10-02","2024-04-12","2023-08-30","2024-05-23","2023-08-17","2023-05-04","2023-05-04","2023-07-06","2023-08-30","2023-08-29","2023-06-22","2024-07-17","2024-07-18","2024-10-11","2023-08-30","2023-07-14","2023-09-06","2023-08-17","2025-04-22","2024-07-29","2023-07-06","2024-08-05","2022-11-01","2022-08-12","2022-09-08","2022-08-19","2022-08-19"],"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":[["","","MNEXSPIKE 2025-2026 (12Y UP)","","","Select","Select",""],["","","METHOTREXATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","ANASTROZOLE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","XIIDRA","","","Select","Select",""],["","","NALTREXONE HCL","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","ROPINIROLE HCL","","","Select","Select",""],["","","HYDROXYCHLOROQUINE SULFATE","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","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":""}]}]}