{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Timothy C Cook","gend":0,"currentgend":"","add":"646 HARPSWELL RD","city":"BRUNSWICK","state":"ME","zip":"04011","dob":"1954-07-15","age":"","mstatus":"","insh":"10000098256","cliId":"","pno":"2074062250","cno":"","email":"timcook1954@gmail.com","ename":"","eno":"","pphy":"KAPLAN, ALLAN J","ppno":"2073736848","pcpadd":"22 STATION AVE,SUITE 101","pcpcity":"BRUNSWICK","pcpstate":"ME","pcpzip":"40112092","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"646 HARPSWELL RD","madd2":"","madd3":"","mcity":"BRUNSWICK","mstate":"ME","mzip":"04011","pcpfaxno":"2073736849","pcpnpi":"1639194376","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1G33WY4HT96","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S51012A","F513","Z01818","M7022","B029","M1711","Z1389","L2489","D8481","J449","C321","Z01810","I2510","E785","I10","R5383","E119","L309","N529","Z01811","Z902","F17200","A000","Z96651","R1310","Z471","E669","K219","G8918","Z0000","J189","J9601","J90","R9089","R4182","R590","R918","K5730","R932","R1313","Z48813","J939","Z4682","R059","J9691","J984","Z452","R509","Z515","R1312","K2100","K2970","I700","A419","C760","L308","U071","C3490","R296","R911","J690","R0600","Z713","T17300A","R0602","Z87891","Z85819","Z931","Z431","K449","R942","T17928A","W44F3XA","E039","K9420","R0902","R410","L609","R400","C3412","R21","K9429","M7021","J441","L03311","Z8709","M799","J439","L7682","K8020","K429","Z8521","Z801","R935","R6521","L0390","K9423","Z08","Z85118","Z923","J9621","I5032","J929","J479","R1110","Z136","R1909","J432","Z510","R0781","Z0101","H524","H52223","H5203","H2513","K4090","E1122","H9190","F17210","M25562","R0989","R531","E7800","R55","R0789","S0990XA","S0093XA","I672","I6529","J40","T85528A","I6782","I252","N1831","R1031","Z23"],"date":["2023-04-28","2023-04-28","2023-10-04","2023-09-28","2023-05-17","2023-12-04","2023-05-19","2023-05-25","2023-05-25","2026-02-22","2023-10-18","2023-10-04","2025-07-02","2025-07-23","2025-07-02","2023-08-15","2025-04-02","2024-01-22","2023-08-15","2023-09-08","2026-01-12","2023-09-08","2024-01-29","2023-12-04","2024-07-24","2023-10-20","2023-10-18","2025-07-23","2023-10-18","2025-09-25","2025-10-14","2025-05-19","2026-02-02","2025-04-01","2025-07-23","2023-12-13","2026-02-15","2025-08-04","2023-12-13","2023-12-16","2023-12-16","2026-02-02","2024-08-23","2026-02-23","2025-12-21","2025-05-20","2025-04-24","2023-12-21","2023-12-23","2025-08-26","2026-02-15","2023-12-19","2025-05-19","2025-01-31","2024-01-11","2024-01-19","2024-01-22","2024-01-22","2024-01-07","2025-09-26","2025-01-31","2025-09-16","2024-02-14","2024-02-29","2026-02-23","2025-05-19","2026-01-12","2026-01-05","2025-08-29","2026-02-15","2024-05-21","2024-08-30","2024-08-30","2024-06-05","2024-06-12","2024-06-14","2025-04-01","2024-06-20","2024-06-14","2026-02-02","2024-06-27","2025-12-09","2026-02-12","2025-11-10","2025-08-04","2026-01-12","2025-07-27","2025-09-16","2025-08-04","2026-02-15","2025-08-04","2024-06-04","2024-06-04","2026-02-15","2025-01-31","2024-08-10","2025-12-08","2025-08-05","2025-08-05","2025-08-05","2025-06-22","2025-09-29","2025-05-20","2026-02-02","2026-02-14","2025-10-15","2025-12-16","2025-01-30","2024-07-26","2024-12-20","2024-12-19","2024-12-19","2024-12-19","2024-12-19","2024-12-19","2025-12-30","2025-07-15","2025-09-25","2025-09-25","2023-03-20","2025-10-04","2026-02-23","2025-07-02","2025-03-26","2024-12-17","2025-03-26","2025-03-26","2025-04-01","2025-03-26","2025-12-26","2025-07-22","2025-04-01","2025-05-19","2025-07-15","2025-12-16","2023-01-20"],"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":[["","","METOCLOPRAMIDE","5 MG","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Taro","","","Select","Select",""],["","","TRUEPLUS","","","Select","Select",""],["","","TRUE METRIX","","","Select","Select",""],["","","Mupirocin 2 % Ointment Padagis","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","100 MG","","Select","Select",""],["","","METOPROLOL TART","25 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","LEVOFLOXACIN","750 MG","","Select","Select",""],["","","TRAMADOL","50 MG","","Select","Select",""],["","","EZETIMIBE","10 MG","","Select","Select",""],["","","ATORVASTATIN","80 MG","","Select","Select",""],["","","DULOXETINE","60 MG","","Select","Select",""],["","","HYDROXYZINE HCL","25 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","METOPROLOL SUCC","25 MG","","Select","Select",""],["","","CEFPODOXIME","200 MG","","Select","Select",""],["","","ALBUTEROL\/IPRATROPIUM","3\/0.5 MG\/3","","Select","Select",""],["","","Albuterol 0.083%","2.5 MG","","Select","Select",""],["","","VALACYCLOVIR","1 GM","","Select","Select",""],["","","CEFADROXIL","500 MG","","Select","Select",""],["","","Sulfamethoxazole\/Trimethoprim","800\/160 MG","","Select","Select",""],["","","FAMOTIDINE","20 MG","","Select","Select",""],["","","Erythromycin 0.5 % Ophth Oint B&L","","","Select","Select",""],["","","DRIZALMA SPRINKLE","","","Select","Select",""],["","","HEALTHMART TRUE METRIX","","","Select","Select",""],["","","ONETOUCH DELICA PLUS","","","Select","Select",""],["","","LEVOTHYROXINE","75 MCG","","Select","Select",""],["","","ABRYSVO W\/ DILUENT SYRINGE","","","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","5\/325 MG","","Select","Select",""],["","","ALBUTEROL (","0.083%) 2.5","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.001","","Select","Select",""],["","","ERYTHROMYCIN","0.005","","Select","Select",""],["","","MUPIROCIN","0.02","","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":""}]}]}