{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ernest R Lamarre","gend":0,"currentgend":"","add":"20 STANWOOD ST","city":"Brunswick","state":"ME","zip":"04011","dob":"1942-08-09","age":"","mstatus":"","insh":"10000021170","cliId":"","pno":2077255744,"cno":2078379945,"email":"THELAMARRES@GWI.NET","ename":"","eno":"","pphy":"HINE, JENNIFER L","ppno":2077984400,"pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"20 STANWOOD ST","madd2":"","madd3":"","mcity":"Brunswick","mstate":"ME","mzip":"04011","pcpfaxno":2077984018,"pcpnpi":1922031657,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9TC3X88NT94","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":["R197","M1712","H25813","H2513","H43811","H2181","R300","R030","H2511","N390","I10","R112","R9431","R600","R9720","N401","Z0101","N453","Z1211","D122","D125","N200","K8020","N400","K4020","Z87440","H2512","Z86010","K635","K5730","A419","R1110","N3943","N3289","Z961","R079","R9389","R6889","N281","N451","N503","M25562","G8929","K644","Z23"],"date":["2024-03-13","2025-11-10","2024-03-25","2024-07-08","2024-07-08","2024-07-08","2024-05-01","2024-02-05","2024-10-30","2024-07-08","2024-03-13","2024-03-14","2024-03-13","2024-05-23","2024-06-13","2024-08-14","2023-03-07","2024-03-20","2023-11-27","2023-11-27","2023-11-27","2024-03-13","2024-03-13","2024-03-13","2024-03-13","2024-06-11","2024-10-15","2023-11-27","2023-11-27","2023-11-27","2024-03-13","2024-03-14","2024-06-11","2024-06-11","2024-11-11","2024-03-13","2024-03-13","2023-03-09","2024-07-08","2024-03-20","2024-03-20","2025-06-20","2025-06-20","2024-11-15","2022-11-17"],"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":[["","","ENALAPRIL MALEATE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","ATENOLOL","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","CEFPODOXIME PROXETIL","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","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":""}]}]}