{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joseph J Dube","gend":0,"currentgend":"","add":"111 PINEWOODS RD","city":"LISBON","state":"ME","zip":"04250","dob":"1948-03-13","age":"","mstatus":"","insh":"10000060329","cliId":"","pno":2073534257,"cno":2077541928,"email":"Dube813@roadrunner.com","ename":"","eno":"","pphy":"TAYLOR, ISABELLA","ppno":2077952800,"pcpadd":"CMMC Family Medicine Residency Program,76 High St Ste 200","pcpcity":"Lewiston","pcpstate":"ME","pcpzip":"04240","pcpcounty":"","pcpid":"","pcpname":"CMMC FAMILY MEDICINE RESIDENCY PROGRAM","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"111 PINEWOODS RD","madd2":"","madd3":"","mcity":"LISBON","mstate":"ME","mzip":"04250","pcpfaxno":"","pcpnpi":1235696600,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9K87NA2HP60","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R0603","I2510","I517","I351","I340","K317","B3781","K449","J441","J440","R079","S59912A","H9121","I4892","I110","I509","E119","H903","S92414A","K2980","K2090","Z95810","S61422A","W268XXA","I440","I255","I4891","R059","R0600","J449","D649","Z79899","H6123","I459","Z7901","Z0101","R0602","R0689","Z4502","R918","Z0389","H9190","I10","R0989","R509","R55","S0990XA","S99912A","R531","Z974","Z87891","E039","Z7984","M25579","I428","I5022","I5023","J9601","E871","M25361","R570","Z1211","D122","D123","D124","H6991","D696","Z20822","R001","I471","I4589","I480","H9209","R161","D132","R29818","R279","H9120","H9319","F17200","I200","I959","I4820","D500","R000","R195","I080","R9431","H9202","R599","R4182","I4510","E113393","S82832A","K922","R0609","K3189","I25110","R42","R6889","Z96651","S39012A","S82832P","M25572","M51370","M47816","M4316","Z043","D125","I5043","I429","S8262XA","Z01810","M5459","R262","I4720","D6869","I25119","R069","I5020","E611","H81399","E785","J45909","J310","I2582","Z951","E1159","I209","F17210","I442","D508","S61422D","K8020","J90","J9811","D62","I25810","E113293","Z0000","Z5181","R0789","R002","I499","I484","Z950","T420X1A","Z09","M7981"],"date":["2025-05-09","2025-08-28","2025-02-17","2025-02-17","2025-02-17","2024-05-31","2024-05-31","2024-05-31","2025-05-05","2023-08-24","2025-09-03","2024-04-22","2024-04-03","2024-06-08","2025-08-12","2025-08-07","2025-04-19","2024-04-03","2024-05-22","2024-05-31","2024-05-31","2025-08-28","2024-06-29","2024-06-29","2025-02-16","2025-09-03","2025-08-28","2024-04-19","2025-08-06","2025-08-06","2025-09-02","2024-06-08","2024-06-20","2023-08-24","2025-07-31","2025-05-19","2025-09-03","2023-08-24","2025-01-15","2023-11-03","2025-08-12","2023-02-10","2025-05-29","2025-06-01","2023-03-03","2025-06-12","2025-06-12","2025-06-24","2025-06-12","2024-01-23","2023-11-03","2025-01-09","2025-01-09","2025-07-18","2025-08-12","2025-08-28","2025-08-12","2025-08-12","2025-08-12","2024-04-08","2025-09-03","2024-12-24","2024-12-24","2024-12-24","2024-12-24","2023-01-12","2025-02-17","2023-04-20","2024-10-10","2023-03-03","2023-03-03","2024-11-20","2023-01-11","2023-01-09","2023-05-23","2023-01-17","2023-01-16","2023-01-16","2023-01-16","2023-10-05","2023-02-15","2023-02-13","2025-06-24","2023-02-15","2023-04-15","2023-02-11","2023-02-13","2023-02-11","2023-04-19","2023-04-19","2025-09-03","2025-09-03","2024-11-19","2025-07-22","2025-02-16","2025-07-30","2023-02-15","2024-10-07","2024-04-03","2025-07-24","2024-04-08","2024-11-09","2025-09-03","2025-07-22","2024-11-09","2024-11-09","2024-11-09","2025-06-12","2024-12-24","2025-08-09","2025-08-09","2025-06-12","2023-04-21","2024-11-20","2025-09-03","2024-12-12","2024-07-19","2023-12-06","2025-05-09","2025-03-19","2023-10-09","2023-09-26","2023-09-13","2023-10-05","2023-10-05","2024-10-07","2024-10-07","2024-10-04","2024-10-07","2024-10-05","2024-10-10","2023-09-25","2024-07-09","2025-06-01","2025-06-01","2025-06-01","2025-02-17","2024-07-11","2024-05-14","2024-07-09","2022-11-01","2022-11-04","2022-11-14","2022-11-14","2022-10-18","2022-10-18","2022-09-17","2022-09-16","2022-08-19"],"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":[["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","AMIODARONE HCL","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","CEFDINIR","","","Select","Select",""],["","","DAPAGLIFLOZIN","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","ENTRESTO","","","Select","Select",""],["","","RANOLAZINE ER","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","GAVILYTE-C","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","PEG-3350 AND ELECTROLYTES","","","Select","Select",""],["","","PEG 3350-ELECTROLYTE","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","MIDODRINE HCL","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","FARXIGA","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","SOD SULF-POTASS SULF-MAG SULF","","","Select","Select",""],["","","GAVILYTE-N","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","METFORMIN ER OSMOTIC","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","CIPROFLOXACIN-DEXAMETHASONE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","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":{"indx":[],"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":""}]}]}