{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Clarence T Robinson","gend":0,"currentgend":"","add":"16 PHEASANT WAY","city":"Hermon","state":"ME","zip":"04401","dob":"1957-06-12","age":"","mstatus":"","insh":"10000096827","cliId":"","pno":"2073561744","cno":"","email":"ROBISON159@YAHOO.COM","ename":"","eno":"","pphy":"TAGUE, COURTNEY","ppno":"2078664399","pcpadd":"EMMC Orono Family Medicine,84 Kelley Rd","pcpcity":"Orono","pcpstate":"ME","pcpzip":"04473","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE BREWER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"16 PHEASANT WAY","madd2":"","madd3":"","mcity":"Hermon","mstate":"ME","mzip":"04401","pcpfaxno":"2078664538","pcpnpi":"1679953194","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6KD9EE6XR34","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0000","D469","R053","E041","Z87891","Z9484","M4807","M5432","M79605","C946","R269","M5416","M5136","M5417","I82402","R918","R000","J690","I21A1","N179","Z9481","I82463","Z5111","I82403","J189","I214","B449","D84821","Z7901","R059","L820","J849","R220","M48061","B441","R942","J45909","C9201","M5127","M5137","M47817","I82409","Z7951","B440","Z006","J479","I252","L821","R0602","Z87898","Z48813","J9811","Z452","Z125","R0600","T8609","C4442","Z79899","D89813","Z85828","Z5189","C4492","M4727","M4726","L570","L814","D1801","Z7189","L989","D0439","E042","D485","M7989","H6123","Z0101","H5203","H524","H52203","R1310","R6330","J4481","D89811","D61818","Z01818","Z0182","R1011","D46Z","B4489","D759","Z20822","K810"],"date":["2025-09-25","2025-04-30","2024-11-17","2023-08-29","2026-02-27","2025-10-06","2023-05-26","2023-06-16","2023-06-16","2023-06-16","2023-06-16","2025-06-19","2023-06-27","2023-07-31","2023-06-23","2024-03-11","2023-07-12","2023-07-15","2023-07-15","2023-07-15","2023-08-28","2023-07-13","2023-12-04","2024-01-10","2023-10-11","2023-07-31","2023-08-03","2023-08-03","2023-09-01","2023-08-28","2023-07-17","2023-07-17","2023-08-29","2025-04-30","2023-10-24","2023-09-06","2026-02-27","2023-08-02","2023-05-26","2023-05-26","2023-05-26","2023-08-01","2023-10-24","2024-11-17","2024-03-11","2025-02-19","2024-01-10","2025-10-14","2024-12-04","2024-01-10","2024-02-21","2024-02-21","2025-12-17","2024-05-16","2025-09-04","2025-05-19","2024-12-09","2024-12-09","2025-03-13","2025-03-13","2024-12-12","2025-06-10","2025-04-30","2025-03-05","2025-10-14","2025-10-14","2025-10-14","2025-10-14","2025-09-18","2025-12-04","2024-08-29","2025-10-14","2024-10-09","2024-11-15","2024-10-09","2024-10-09","2024-10-09","2024-10-09","2024-10-09","2024-10-09","2025-05-12","2025-05-12","2023-02-24","2023-02-08","2023-02-07","2023-02-07","2023-02-01","2023-02-01","2023-02-01","2023-02-03","2023-01-18"],"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":[["","","ELIQUIS STARTER PACK","","","Select","Select",""],["","","BUDESONIDE","0.25 MG\/2","","Select","Select",""],["","","NYAMYC","","","Select","Select",""],["","","LEVOFLOXACIN","500 MG","","Select","Select",""],["","","HYDROMORPHONE","2 MG","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","FLUAD","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","BACLOFEN","20 MG","","Select","Select",""],["","","CYCLOBENZAPRINE","5 MG","","Select","Select",""],["","","ACYCLOVIR","400 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","400\/80 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","FLUTICASONE PROP\/SALMETEROL","500\/50 MCG","","Select","Select",""],["","","WIXELA INHUB","","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","Albuterol\/Ipratropium","3\/0.5 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","MONTELUKAST","10 MG","","Select","Select",""],["","","GABAPENTIN","100 MG","","Select","Select",""],["","","INCRUSE ELLIPTA","","","Select","Select",""],["","","TACROLIMUS","1 MG","","Select","Select",""],["","","IBU","","","Select","Select",""],["","","JAKAFI","","","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","5\/325 MG","","Select","Select",""],["","","BREYNA","","","Select","Select",""],["","","ENOXAPARIN PF","60 MG\/0.6","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","100 MG","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","Nystatin 100","","","Select","Select",""],["","","ATOVAQUONE","750 MG\/5","","Select","Select",""],["","","OLANZAPINE","5 MG","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","URSODIOL","300 MG","","Select","Select",""],["","","ONDANSETRON","8 MG","","Select","Select",""],["","","ZARXIO","","","Select","Select",""],["","","CHLORHEXIDINE","0.0012","","Select","Select",""],["","","SPIKEVAX","","","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":""}]}]}