{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lynda E Dickinson","gend":1,"currentgend":"","add":"315 NORRIDGEWOCK RD","city":"FAIRFIELD","state":"ME","zip":"04937","dob":"1946-07-12","age":"","mstatus":"","insh":"10000037853","cliId":"","pno":"2074537700","cno":"2076605982","email":"norm.lynda.d@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 - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"315 NORRIDGEWOCK RD","madd2":"","madd3":"","mcity":"FAIRFIELD","mstate":"ME","mzip":"04937","pcpfaxno":2078735461,"pcpnpi":1871559203,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3EQ2CP6VD93","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R059","M40204","I700","J441","F17210","R5383","D649","E039","R197","K469","D539","R634","I10","R194","D509","K635","D123","K5730","Z0001","J90","R918","J9811","R0989","R062","J189","K222","K4090","S6991XA","S32512A","S32592A","M810","S3219XD","Z0000","S3282XA","R944","Z13820","K551","I771","Z7982","W010XXA","I352","R600","S3289XD","X58XXXD","F17200","R55","F419","F4321","E876","K2900","R112","K529","R109","Z1231","S32592D","F418","M51369","I7090","Z681","W010XXD","D62","K2950","R001","K3189","K6389","D72829"],"date":["2024-04-12","2023-05-30","2023-05-30","2025-12-03","2026-02-19","2023-09-19","2026-03-04","2024-12-19","2023-07-17","2023-07-17","2023-09-19","2025-11-14","2026-01-12","2023-11-17","2026-01-21","2023-12-08","2023-12-08","2023-12-08","2024-01-04","2024-04-12","2024-04-12","2024-04-12","2024-04-12","2024-04-12","2024-05-23","2025-12-04","2025-05-08","2025-10-07","2025-10-16","2025-10-16","2026-02-02","2025-11-03","2025-01-07","2025-10-16","2026-03-04","2026-03-04","2025-10-27","2025-10-09","2025-10-16","2025-10-16","2025-01-14","2026-01-12","2025-11-08","2025-11-03","2025-11-03","2026-01-18","2026-02-19","2026-02-19","2025-09-30","2025-09-30","2025-09-29","2025-09-29","2025-09-29","2025-01-22","2026-01-12","2026-01-07","2026-01-12","2026-01-12","2025-11-14","2026-01-12","2025-11-19","2025-12-04","2025-05-02","2025-09-29","2025-09-29","2025-09-29"],"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":[["","","LEVOFLOXACIN","500 MG","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","LISINOPRIL","10 MG","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","FLUAD","","","Select","Select",""],["","","LISINOPRIL\/HYDROCHLOROTHIAZIDE","20\/25 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","SERTRALINE","50 MG","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","HYDRALAZINE","25 MG","","Select","Select",""],["","","CLOPIDOGREL","75 MG","","Select","Select",""],["","","POTASSIUM CL","20 MEQ","","Select","Select",""],["","","Alendronate","70 MG","","Select","Select",""],["","","Fluad Quad 2023-2024","","","Select","Select",""],["","","PRAVASTATIN","20 MG","","Select","Select",""],["","","LORAZEPAM","0.5 MG","","Select","Select",""],["","","TRAMADOL","50 MG","","Select","Select",""],["","","Albuterol 0.083%","2.5 MG","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","LEVOTHYROXINE","75 MCG","","Select","Select",""],["","","FLUAD QUAD","","","Select","Select",""],["","","ALBUTEROL (","0.083%) 2.5","","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":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""],[""]],"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":""}]}]}