{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Janet A Zimmerman","gend":1,"currentgend":"","add":"8 N STAR WAY","city":"BRUNSWICK","state":"ME","zip":"04011","dob":"1947-10-03","age":"","mstatus":"","insh":"10000083667","cliId":"","pno":2077124331,"cno":"","email":"jazjogger@gmail.com","ename":"","eno":"","pphy":"RIEHL, JENNIFER M","ppno":2074067600,"pcpadd":"Mid Coast Medical Group Topsham Internal Medicine,1 Wellness Way Ste A","pcpcity":"Topsham","pcpstate":"ME","pcpzip":"04086","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"8 N STAR WAY","madd2":"","madd3":"","mcity":"BRUNSWICK","mstate":"ME","mzip":"04011","pcpfaxno":2074067601,"pcpnpi":1700897618,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1GR3K17WV98","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M8580","S93401A","N1831","T452X1D","D75839","I10","R052","Z7689","N281","N289","M79671","C50212","Z170","S8265XD","M19071","Z79811","R928","R92332","Z0000","S82832A","I129","D225","L578","Z872","L700","N814","C50912","Z803","Z510","Z01419","R6889","Z780","N362","N952","R5383","N6489","R92333","H527","H04123","M25572","R053","D508","S8265XA","E785","E673","L853","Z1231","F419","H903","M8589","S93411A","M25472","N6321","N6322","Z1721","Z1732","M5030","I471","I498","E8352","R002"],"date":["2025-05-20","2025-04-17","2025-08-28","2023-11-13","2024-08-22","2025-08-22","2023-03-31","2023-03-31","2024-05-17","2024-05-17","2025-05-08","2025-11-11","2025-11-11","2025-06-17","2025-04-30","2025-11-11","2024-09-11","2024-09-11","2025-08-28","2025-05-06","2025-08-28","2024-05-23","2024-05-23","2024-05-23","2023-01-26","2025-10-21","2024-10-02","2024-11-27","2024-12-10","2023-10-18","2023-05-03","2023-10-18","2023-10-18","2023-10-18","2025-11-11","2025-09-04","2025-09-04","2024-03-13","2024-03-13","2025-05-06","2024-05-03","2024-05-03","2025-05-20","2025-08-28","2023-09-29","2024-05-23","2024-09-03","2024-10-21","2024-01-31","2025-01-23","2025-04-17","2025-05-06","2024-09-09","2024-09-09","2024-10-21","2024-10-21","2022-10-12","2022-09-12","2022-09-12","2022-08-18","2022-09-09"],"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":[["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","MNEXSPIKE 2025-2026 (12Y UP)","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","LETROZOLE","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","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":""}]}]}