{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Paul A Ducharme","gend":0,"currentgend":"","add":"61 MALLARD LN","city":"WINTHROP","state":"ME","zip":"04364","dob":"1945-03-21","age":"","mstatus":"","insh":"10000062519","cliId":"","pno":2073772815,"cno":"","email":"skyyla@roadrunner.com","ename":"","eno":"","pphy":"STADNICKI, MICHAEL R","ppno":2077537655,"pcpadd":"12 HIGH ST,STE 302","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42407634","pcpcounty":"","pcpid":"","pcpname":"CENTRAL MAINE FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"61 MALLARD LN","madd2":"","madd3":"","mcity":"WINTHROP","mstate":"ME","mzip":"04364","pcpfaxno":2077537656,"pcpnpi":1831179803,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2V38R04AW58","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G309","R9431","I517","R29818","Z0100","Z95818","I639","R319","R300","R350","R3915","M5450","R0789","F0280","G238","R9089","B351","M79675","M79674","I6523","R531","R471","M4802","M50223","M50222","R29898","G459","C44529","F0390","F02B0","I6782","G9389","R410","R079","I493","Z8679","N400","M4800","M1711","R7989","R634","R454","I4891","N5089","L0291","H2513","F03A0","R2689","Z8673","U071","E7800","F39","R197","M11261","W1839XA","Z20822","R200","Z0000","M879","R229","R001","R222","I440","R6889","H25813","H5213","I38","I358","I491","R52","F03B0","L600","L853","N509","H6120","H6121"],"date":["2025-11-12","2023-08-28","2023-08-28","2023-09-25","2025-04-04","2025-10-13","2025-10-13","2025-03-10","2025-03-10","2025-03-10","2025-03-10","2025-03-10","2025-03-26","2023-09-10","2023-09-10","2023-09-10","2025-10-23","2025-10-23","2025-10-23","2023-09-26","2023-09-28","2023-09-26","2023-10-24","2023-09-28","2023-09-28","2023-09-28","2025-11-04","2023-09-20","2025-05-24","2023-09-10","2023-09-26","2023-09-26","2025-04-01","2025-04-01","2025-11-04","2025-11-04","2025-03-10","2023-10-02","2024-04-12","2024-05-29","2024-05-29","2024-05-29","2024-02-02","2023-12-05","2023-07-18","2025-07-16","2023-11-09","2023-09-26","2024-01-24","2023-12-17","2024-05-01","2024-08-01","2024-08-01","2023-03-27","2023-09-28","2023-09-27","2023-09-28","2025-02-05","2023-07-05","2023-07-05","2023-09-28","2023-07-26","2023-09-26","2022-09-02","2025-04-09","2024-09-09","2023-10-20","2024-12-26","2023-09-15","2023-10-24","2025-04-15","2025-05-29","2022-11-22","2022-10-19","2022-08-09","2022-08-09"],"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":[["","","MEMANTINE HCL","","","Select","Select",""],["","","CITALOPRAM HBR","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","RIVASTIGMINE","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","MEMANTINE HCL ER","","","Select","Select",""],["","","DONEPEZIL HCL","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","AMMONIUM LACTATE","","","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":[]}},{"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":""}]}]}