{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Tina L Johnson","gend":1,"currentgend":"","add":"66 N VILLAGE RD","city":"CAPE NEDDICK","state":"ME","zip":"03902","dob":"1943-01-18","age":"","mstatus":"","insh":"10000052994","cliId":"","pno":2073324035,"cno":2073324035,"email":"tinated46@gmail.com","ename":"","eno":"","pphy":"PATEL, ATIT","ppno":2073638430,"pcpadd":"46 BARRA RD STE 201202,","pcpcity":"BIDDEFORD","pcpstate":"ME","pcpzip":"40059459","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"66 N VILLAGE RD","madd2":"","madd3":"","mcity":"CAPE NEDDICK","mstate":"ME","mzip":"03902","pcpfaxno":2072943541,"pcpnpi":1144841107,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7CM5EX8KF52","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D509","K9189","C50511","Z8551","R739","K319","M1711","D125","K621","K3189","K2100","K449","R4182","Z471","K5901","K219","D508","Z853","I498","M47812","Z96651","Z4682","S86911A","H103","J069","R42","R0902","M1812","R000","K430","D62","E611","Z0101","H524","Z9012","K2211","K254","H353132","H2513","H40011","R3129","R82998","D649","Z0000","R918","J929","I2510","K2289","R1011","R0602","C675","Z8553","K263","K311","E7800","R221","K269","R1310","C679","K6389","R140","Z905","N959","R0789","S0501XA","M19072","M7732","R6889","K440","K640","K6289","Z09","Z01818","K2090","K635","K5730","K255","E785","G8918","J90","J8410","J9811","J982","J939","M25561","Z452","J189","S20211A","R112","H00025","D3132","H43813","H5203","L249","R490"],"date":["2025-02-07","2024-03-09","2024-05-23","2025-09-26","2024-12-14","2025-11-04","2024-05-14","2023-11-01","2023-11-01","2025-11-04","2025-11-04","2025-11-04","2024-06-18","2024-03-06","2023-11-15","2025-10-27","2023-11-15","2025-08-25","2024-03-08","2025-07-10","2025-08-19","2024-03-09","2023-01-31","2023-11-28","2023-11-28","2024-08-20","2024-02-28","2024-10-14","2024-02-28","2024-02-29","2024-03-09","2025-02-11","2024-11-07","2024-11-07","2023-05-10","2024-03-09","2024-03-09","2024-11-07","2023-05-02","2023-05-02","2023-05-03","2023-05-03","2024-06-24","2024-12-19","2025-08-21","2025-08-21","2024-10-14","2024-10-14","2023-07-12","2025-02-17","2025-05-20","2025-08-25","2024-03-08","2024-03-09","2024-06-19","2025-05-20","2024-03-08","2025-08-21","2023-05-03","2024-03-08","2024-03-08","2024-03-08","2025-04-22","2023-04-21","2023-05-24","2024-06-24","2024-06-24","2023-04-26","2025-10-27","2023-11-01","2023-11-01","2024-06-18","2024-02-09","2025-10-27","2023-11-01","2024-02-28","2024-03-02","2025-11-04","2024-02-26","2025-05-13","2025-05-13","2025-05-13","2024-03-03","2024-03-03","2023-02-13","2024-02-28","2024-02-28","2024-10-14","2024-03-08","2024-02-16","2022-11-01","2022-11-01","2022-11-01","2022-09-14","2022-06-21"],"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":[["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","METOCLOPRAMIDE HCL","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","VOQUEZNA","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","IBU","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","DICYCLOMINE HCL","","","Select","Select",""],["","","TOBRAMYCIN","","","Select","Select",""],["","","PLENVU","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","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":""}]}]}