{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Fulton J Pinette","gend":0,"currentgend":"","add":"58 Water St","city":"Brunswick","state":"ME","zip":"04011","dob":"1956-04-09","age":"","mstatus":"","insh":"10000087586","cliId":"","pno":2077981813,"cno":"","email":"lmcaesar52@yahoo.com","ename":"","eno":"","pphy":"Elizabeth Flory","ppno":2077984400,"pcpadd":"Martins Point Health Care,114 Bath Rd","pcpcity":"Brunswick","pcpstate":"ME","pcpzip":"04011","pcpcounty":"","pcpid":"","pcpname":"Martins Point Health Care","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"58 Water St","madd2":"","madd3":"","mcity":"Brunswick","mstate":"ME","mzip":"04011","pcpfaxno":2077984018,"pcpnpi":1659865970,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9FK7PD8YP58","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K56600","C412","F329","J690","J95821","M8458XA","D492","R222","H40003","Z428","Z481","M9903","M5450","M9904","M461","M5416","G9340","G834","G4730","G935","R4182","C720","Z4789","R7303","E785","M23242","M1712","Z23","H6121","M25562","M7061","F320","I499","K219","N400","I10","F330","M549","Z0389","M7989","G9529","G4733","F32A","G9600","G9782","M96830","Z981","E6609","M533","M546","G9520","R29898","M79605","M8580","Z9181","L570","R262","M79604","Z125","M160","L219","L578","D225","L814","C44311","C44519","F411","N401","T8149XA","Z452","Z4682","R918","J811","M898X8","H903","R112","M5134","M799","S72002D","M1612","C7951","C801","Z0189","M25551","M25552","R2689","L723","A000","M47817","D649","K56609","M79674","M79675","B351","T8149XD","G8929","Z7409","M419","Z98890","K56699","G96810","D72829","K2100","L89153","Z8719","S32009A","M5117","Z85830","M898X9","K5790","N323","R109","R279","Z96698","I6200","R0682","D447","M6281","T8142XA","R6889","S32059A","M48061","Z471","M47816","I7121","R569","M85862"],"date":["2024-12-07","2025-04-17","2022-10-14","2023-03-08","2023-03-09","2023-03-08","2024-05-29","2023-01-31","2024-08-05","2023-03-15","2023-03-15","2023-01-10","2023-08-28","2023-01-10","2023-01-10","2023-03-13","2023-03-13","2023-04-30","2023-03-15","2023-03-15","2023-03-15","2023-07-17","2024-02-19","2024-10-28","2024-10-28","2024-03-14","2024-03-14","2024-11-04","2022-08-08","2025-04-17","2023-04-26","2023-04-26","2023-03-13","2023-07-24","2024-07-01","2024-08-21","2024-08-21","2023-03-23","2023-03-01","2023-03-05","2023-02-03","2023-04-20","2023-05-04","2023-03-17","2023-03-17","2023-03-15","2024-10-29","2023-04-20","2023-08-28","2023-08-28","2023-02-24","2024-03-20","2023-01-09","2024-02-28","2023-06-13","2024-05-29","2022-12-29","2022-12-29","2023-01-25","2024-02-19","2024-05-29","2024-05-29","2024-05-29","2024-05-29","2024-10-08","2024-09-10","2023-06-27","2023-05-04","2023-04-30","2023-03-08","2023-03-08","2023-03-11","2023-03-09","2023-02-06","2022-09-14","2024-12-06","2024-02-19","2024-02-28","2023-01-13","2023-01-13","2023-02-03","2023-02-03","2023-03-15","2023-04-06","2022-11-22","2023-03-22","2025-06-09","2023-02-11","2022-11-22","2024-10-28","2024-12-09","2025-07-10","2025-07-10","2025-07-10","2023-04-17","2024-03-20","2024-03-20","2024-07-20","2023-06-26","2024-12-06","2023-03-16","2023-03-17","2023-07-11","2023-07-11","2024-12-24","2023-08-27","2023-08-27","2023-08-27","2023-01-30","2023-01-30","2024-07-01","2023-03-16","2023-05-01","2024-10-29","2023-03-15","2023-03-11","2023-08-28","2023-03-13","2023-03-17","2023-07-02","2023-08-27","2023-01-13","2023-03-14","2023-03-14","2024-07-01","2023-03-09","2024-02-28"],"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":[["","","LANSOPRAZOLE","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","Select","Select",""],["","","RAMELTEON","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","NALOXONE HCL","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","PREDNISONE","","","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":""}]}]}