{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ronald P Paquette","gend":0,"currentgend":"","add":"383 POND RD","city":"Albion","state":"ME","zip":"04910","dob":"1941-05-03","age":"","mstatus":"","insh":"10000030889","cliId":"","pno":2074379237,"cno":"","email":"upbeatruns@gmail.com","ename":"","eno":"","pphy":"CHAMBERLAIN, DEAN E","ppno":2074379388,"pcpadd":"Lovejoy Health Center,7 School St Ste 1","pcpcity":"Albion","pcpstate":"ME","pcpzip":"04910","pcpcounty":"","pcpid":"","pcpname":"LOVEJOY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"383 POND RD","madd2":"","madd3":"","mcity":"Albion","mstate":"ME","mzip":"04910","pcpfaxno":2076261849,"pcpnpi":1922360411,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8Y85FX2CH73","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0000","D539","Z1211","E789","N400","R5383","M9903","M5136","M5450","M542","L570","Z1283","Z85828","Z85820","D120","D122","D123","H5213","H524","H52223","H47022","R6889","I083","C44319","L905","L821","L814","C44311","Z23","I361","I517","I4820","E7849","Z1212","R0602","H40023","R7989","I4811","D649","E7800","I081","Z0101","I6200","S065X0D","R531","S065X0A","W19XXXA","Z789","S065XAA","M5116","M4726","M5117","M160","I609","G935","R42","M4186","I6202","M5410","M6281","I611","I4891","R4182","F419","E639"],"date":["2025-06-18","2025-11-04","2024-09-16","2024-06-06","2024-06-06","2024-06-06","2024-07-23","2024-07-23","2024-07-23","2024-07-23","2025-08-05","2024-04-22","2023-10-23","2024-04-22","2024-09-16","2024-09-16","2024-09-16","2025-05-13","2025-05-13","2025-05-13","2025-06-16","2023-12-21","2025-10-15","2025-08-05","2025-08-05","2025-08-05","2025-08-05","2025-08-05","2025-10-17","2023-10-05","2023-08-29","2025-09-16","2023-08-29","2024-08-06","2025-07-11","2025-06-16","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2025-10-15","2022-11-03","2022-11-17","2022-11-17","2022-10-17","2022-10-17","2022-10-17","2022-10-17","2022-10-18","2022-10-11","2022-10-11","2022-10-11","2022-10-11","2022-10-17","2022-10-18","2022-10-17","2022-10-11","2022-10-18","2022-10-13","2022-10-13","2022-10-17","2022-10-17","2022-10-18","2022-09-29","2022-09-29"],"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":[["","","HYDROXYZINE HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","LEVETIRACETAM","","","Select","Select",""],["","","TRAMADOL HCL","","","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":""}]}]}