{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ronald J Leclair","gend":0,"currentgend":"","add":"340 BATH RD APT 220","city":"Brunswick","state":"ME","zip":"04011","dob":"1934-02-05","age":"","mstatus":"","insh":"10000038102","cliId":"","pno":2077511427,"cno":"","email":"leclair.jean@icloud.com","ename":"","eno":"","pphy":"MITCHELL, KRISTEN N","ppno":2076023571,"pcpadd":"University Healthcare,655 Main St","pcpcity":"Saco","pcpstate":"ME","pcpzip":"04072","pcpcounty":"","pcpid":"","pcpname":"MATURE CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"340 BATH RD APT 220","madd2":"","madd3":"","mcity":"Brunswick","mstate":"ME","mzip":"04011","pcpfaxno":2072829180,"pcpnpi":1558561332,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1HU1YN8WG09","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":["H35373","E113293","E538","Z89512","B351","M79674","M19071","L570","L820","S88112D","R4701","M25561","G8929","E1141","Z794","E1165","E1169","K222","E1159","R296","A000","H35363","H527","M79675","B3781","K449","S99921A","L89890","S81802D","I872","E782","G629","I69351","E119","K2289","Z7902","K3189","E113393","S81802S","R1310","Z85820","L821","Z872","I639","R4182","R6889","Z4781","E1149","M79671","I129","E1122","N189","L03213","Z5189","Z23","D225"],"date":["2023-08-16","2025-10-27","2024-08-15","2025-11-07","2025-08-05","2025-08-05","2023-06-16","2024-07-25","2024-07-25","2025-11-05","2024-05-03","2024-05-03","2024-05-03","2024-08-21","2025-07-02","2025-07-02","2024-08-21","2025-07-18","2023-06-01","2025-05-02","2025-09-20","2025-10-27","2025-10-27","2025-05-05","2025-07-18","2025-07-18","2023-06-16","2025-11-07","2025-11-07","2025-11-07","2024-05-14","2023-03-24","2023-03-24","2025-10-03","2024-09-04","2024-09-04","2024-09-04","2024-08-23","2025-08-21","2025-07-18","2023-07-20","2023-07-20","2023-07-20","2025-07-18","2025-07-18","2023-09-13","2025-05-07","2023-09-13","2023-05-24","2024-09-04","2024-09-04","2024-09-04","2024-04-26","2025-09-02","2022-10-17","2022-09-08"],"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":[["","","INSULIN SYRINGE","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","ACCU-CHEK SOFTCLIX","","","Select","Select",""],["","","ACCU-CHEK GUIDE TEST STRIP","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","NOVOLIN N","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","ULTRA-FINE INSULIN SYRINGE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","SAFETYGLIDE INSULIN SYRINGE","","","Select","Select",""],["","","CEFDINIR","","","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":""}]}]}