{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Dennis M Hurteau","gend":0,"currentgend":"","add":"58 OVERLOOK DR","city":"Buxton","state":"ME","zip":"04093","dob":"1953-08-02","age":"","mstatus":"","insh":"10000070461","cliId":"","pno":6037676525,"cno":"","email":"hurteaus181@gmail.com","ename":"","eno":"","pphy":"MERCIER, CHRISTOPHER F","ppno":2078392559,"pcpadd":"Martins Point Health Care,331 Veranda St","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04103","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"58 OVERLOOK DR","madd2":"","madd3":"","mcity":"Buxton","mstate":"ME","mzip":"04093","pcpfaxno":2075231135,"pcpnpi":1396151619,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3XG8PE0RN34","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":["R1011","G8929","K5900","M25511","R0789","M9900","M9901","M9902","M546","Z0101","I10","R222","R109","N401","Z23","E119","Z87891","I701","I700","M549","M19011","R1031","R339","R600","M75111","R002","N2889","M47814","M4604","N138","E871","R140","Z87442","N1330","R413","R634","E785","R079","R531","R55","Z20822","I213","R4182","R29818","I4510","M75121","K638219","R300","D123","H18512","K2100","K219","M7910","I110","R5382","I5032","K648","K222","K31819","R1030","I5030","M898X8","L572","M75101","R0781","Z125","N50819","H5111","R059","J988","A049","R251","K9089","K449","K4090","K429"],"date":["2025-04-02","2025-08-20","2025-07-07","2025-09-02","2024-03-18","2024-01-05","2024-01-05","2023-11-22","2024-01-05","2025-05-08","2024-02-08","2024-02-08","2025-07-07","2025-07-03","2024-11-01","2025-10-30","2025-05-30","2025-05-02","2025-05-02","2025-07-07","2025-03-19","2025-04-02","2025-05-30","2024-04-10","2025-03-19","2025-09-03","2024-01-03","2024-04-11","2023-11-29","2025-07-03","2024-04-29","2024-09-26","2025-07-03","2025-04-23","2024-10-29","2024-10-29","2025-10-30","2024-03-16","2024-03-16","2024-03-17","2024-03-16","2024-03-16","2024-03-16","2024-03-16","2024-03-18","2025-03-17","2025-09-02","2025-01-10","2023-09-29","2025-09-08","2023-09-29","2023-09-29","2023-09-11","2025-10-15","2025-09-25","2025-10-30","2023-09-29","2023-09-29","2023-09-29","2025-08-20","2025-10-15","2022-11-28","2022-11-14","2022-11-14","2022-11-14","2022-08-24","2022-08-22","2022-07-13","2022-06-22","2022-06-22","2022-05-31","2022-05-27","2022-05-17","2022-04-03","2022-04-03","2022-04-03"],"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":[["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","LINZESS","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","ALFUZOSIN HCL ER","","","Select","Select",""],["","","ONETOUCH ULTRA2","","","Select","Select",""],["","","XIFAXAN","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","DICYCLOMINE HCL","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","CHLORTHALIDONE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","NEOMYCIN SULFATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","OXYCODONE 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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}