{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Richard W Descoteaux","gend":0,"currentgend":"","add":"6 MACAUTHUR AVE","city":"OLD ORCHARD BEACH","state":"ME","zip":"04064","dob":"1974-08-17","age":"","mstatus":"","insh":"10000078654","cliId":"","pno":2072292903,"cno":"","email":"rdescoteaux93@gmail.com","ename":"","eno":"","pphy":"MINNEHAN, KAITLIN","ppno":2078837926,"pcpadd":"MMP Scarborough Family Medicine,300 Professional Dr Ste 2C","pcpcity":"Scarborough","pcpstate":"ME","pcpzip":"04074","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"6 MACAUTHUR AVE","madd2":"","madd3":"","mcity":"OLD ORCHARD BEACH","mstate":"ME","mzip":"04064","pcpfaxno":2078831925,"pcpnpi":1710419312,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7PV1KD1TX93","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N1832","E559","E0822","Z794","K6389","K5730","F411","F79","Z4889","E109","E139","M5450","R2681","M5459","M25511","M6281","G4733","G8929","B354","M9907","M9905","M9903","M9902","I10","Z9641","F419","F32A","K219","D509","K3184","K5792","J3089","F330","F70","K810","J45909","E785","Z136","R0989","K8010","E6601","F840","E1143","R490","K8020","K5732","E1122","I129","N1830","Z0000","R7989","J309","K269","E119","S27321A","K8689","S50312A","Z23","E611","F3289","S27321D","S299XXD","R110","M549","R1011","Z20822","R42","R059","K8510","E1369","K8012","Z87891","K0889","E1343","Z6841","R519","J029","Z09","K760","R162","N281","J392","E66813","F39","D649","M9906","E1169","R1312","R509","Z01818","L729","S299XXA","E113293","Z0100","F339","G5762","E782","M79672","R140","R1310","R112","R0602","Z713","Z6839","R079","R791","E089","J302","R220","R051","E1022","R109","R1084","E133299","E1342","K869","R197","H8110","J40","Z2839","J3489","Z98890","K029","K0499","K2100","S36209S","R0683","S1096XA","W57XXXA","R61","E1021","N529","R630","E138","E10649","E103299","R195","R6889","Z639","Z653","K625","S36209A","R251","Z01812","J0100","J343","J342","S025XXA","H9193"],"date":["2024-08-01","2024-03-27","2024-03-27","2024-03-27","2023-07-02","2025-06-03","2025-11-07","2025-09-19","2025-05-19","2025-06-25","2025-11-05","2023-09-26","2023-06-28","2024-05-22","2024-05-22","2024-05-22","2025-09-03","2023-09-26","2023-09-26","2023-09-26","2023-12-19","2023-09-26","2023-09-26","2023-09-27","2024-07-23","2025-05-13","2025-09-19","2025-05-28","2024-01-02","2025-05-08","2024-01-02","2024-11-20","2023-06-08","2023-06-08","2025-05-28","2025-05-28","2025-05-28","2025-06-03","2023-09-22","2025-05-28","2024-07-23","2024-10-22","2025-06-27","2025-04-23","2025-05-27","2023-07-02","2024-11-15","2023-09-22","2024-03-21","2025-02-13","2025-08-11","2024-05-31","2025-05-08","2025-05-08","2023-01-15","2024-01-30","2023-01-15","2024-10-15","2023-08-03","2024-08-06","2023-01-23","2023-01-23","2025-01-09","2023-05-25","2025-06-03","2024-02-06","2024-10-29","2024-10-15","2025-06-03","2023-09-01","2025-05-28","2025-09-03","2025-09-19","2024-04-17","2024-05-08","2024-10-15","2024-11-02","2025-06-18","2025-06-05","2025-06-05","2025-06-05","2025-09-03","2025-10-16","2023-01-04","2023-07-27","2023-08-03","2023-12-06","2025-04-02","2024-11-02","2025-05-08","2023-06-21","2023-01-15","2024-11-21","2024-11-21","2025-03-11","2025-07-31","2024-07-23","2025-07-31","2025-01-09","2025-01-09","2025-01-09","2025-07-13","2024-05-08","2024-05-08","2025-07-13","2025-07-13","2023-07-19","2024-05-17","2025-07-08","2024-11-05","2023-09-22","2025-07-21","2025-06-03","2023-06-27","2023-06-27","2023-06-27","2025-07-16","2024-10-29","2023-09-14","2023-05-19","2023-11-06","2023-11-06","2025-09-19","2025-09-19","2022-11-09","2022-10-14","2022-09-15","2022-09-06","2022-09-06","2022-09-07","2022-05-23","2022-06-22","2022-05-25","2022-07-25","2022-07-25","2022-07-25","2022-07-28","2022-06-24","2022-04-26","2022-04-26","2022-04-26","2022-04-11","2022-03-28","2021-10-13","2021-10-18","2021-11-11","2021-12-06","2022-01-26","2022-02-15"],"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":[["","","GABAPENTIN","","","Select","Select",""],["","","HUMALOG KWIKPEN U-200","","","Select","Select",""],["","","NALTREXONE HCL","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","ZEGALOGUE AUTOINJECTOR","","","Select","Select",""],["","","NANO 2ND GEN PEN NEEDLE","","","Select","Select",""],["","","DEXCOM G7 SENSOR","","","Select","Select",""],["","","FENOFIBRATE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","BASAGLAR KWIKPEN U-100","","","Select","Select",""],["","","MORPHINE SULFATE","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","PRECISION XTRA","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","LIDOCAINE HCL VISCOUS","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","NOVOLOG","","","Select","Select",""],["","","PIOGLITAZONE HCL","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","LEVEMIR FLEXPEN","","","Select","Select",""],["","","VARIVAX VACCINE","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","DEXCOM G7 RECEIVER","","","Select","Select",""],["","","DEXCOM G6 SENSOR","","","Select","Select",""],["","","DEXCOM G6 TRANSMITTER","","","Select","Select",""],["","","GVOKE HYPOPEN 2-PACK","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","CLONIDINE HCL","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","BUTALBITAL-ACETAMINOPHEN-CAFFE","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","PRAZOSIN HCL","","","Select","Select",""],["","","HUMALOG KWIKPEN U-100","","","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":{"indx":[["","","",""],[],[""],[""],[],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","",""],[],[""],[""],[""],[""],[""],[""]],"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":""}]}]}