{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Paul R Normand","gend":0,"currentgend":"","add":"26 NEW DAM RD","city":"SANFORD","state":"ME","zip":"04073","dob":"1950-08-08","age":"","mstatus":"","insh":"10000092293","cliId":"","pno":2076514157,"cno":"","email":"prnormand50@gmail.com","ename":"","eno":"","pphy":"DUCKER, GAVIN M","ppno":2078731036,"pcpadd":"174 KENNEDY MEMORIAL DR,","pcpcity":"WATERVILLE","pcpstate":"ME","pcpzip":"49015134","pcpcounty":"","pcpid":"","pcpname":"YORK HOSPITAL SANFORD WALK IN CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"26 NEW DAM RD","madd2":"","madd3":"","mcity":"SANFORD","mstate":"ME","mzip":"04073","pcpfaxno":2078613281,"pcpnpi":1013062348,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3X01H35VX97","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C61","Z510","I6523","R9720","Z08","Z8546","Z923","Z0101","H5203","H524","D649","H2513","H40003","H40033","M79675","M47817","I10","R6889","G8929","M479","F17200","R319","M47816","G894","I70213","M7918","Z720","F17210","R4182","Z0000","I739","M5441","M48061","R339","M48062","I70211","M5126","R7301","M5136","E785","M5137","N402","R9389","Z5111","M79671","I7090","Z01810","Z5112","I70201","M4316","H906","R42","E876","H6123"],"date":["2025-10-15","2025-06-18","2025-09-08","2024-11-29","2025-10-15","2025-10-15","2025-10-15","2025-03-28","2025-03-28","2025-03-28","2025-09-16","2025-03-28","2025-03-28","2025-03-28","2023-05-25","2025-09-18","2024-11-06","2023-03-31","2023-05-01","2023-05-01","2023-08-03","2025-07-22","2025-09-18","2023-09-19","2025-08-15","2023-09-19","2024-07-22","2025-06-07","2023-08-17","2025-11-11","2025-09-08","2025-08-07","2025-09-18","2025-06-07","2024-08-05","2023-05-12","2025-09-18","2023-03-16","2023-08-17","2024-07-22","2023-01-23","2024-11-29","2024-12-05","2025-08-19","2023-02-17","2024-07-22","2023-06-26","2025-09-16","2025-08-15","2023-12-12","2022-12-21","2022-11-21","2022-10-20","2022-07-01"],"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":[["","","ATENOLOL","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","COLCHICINE","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}