{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Guy M Lemieux","gend":0,"currentgend":"","add":"138 MT AUBURN AVE UNIT 413","city":"Auburn","state":"ME","zip":"04210","dob":"1957-05-24","age":"","mstatus":"","insh":"10000096410","cliId":"","pno":2075991531,"cno":"","email":"deblemieux@icloud.com","ename":"","eno":"","pphy":"HUTTON, CELESTE A","ppno":2079982100,"pcpadd":"76 HIGH ST,","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42407649","pcpcounty":"","pcpid":"","pcpname":"CENTRAL MAINE INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"138 MT AUBURN AVE UNIT 413","madd2":"","madd3":"","mcity":"Auburn","mstate":"ME","mzip":"04210","pcpfaxno":"","pcpnpi":1790357689,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2QR8DV1UH57","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R059","M9903","M5136","M549","M9904","Z4800","E1152","E871","R58","I739","M7541","M25511","E119","I96","I10","M1990","R55","R531","M47816","M25551","I491","F1090","Z89432","S98112A","Z4801","Z0000","S91309A","I2510","D539","F1020","I4891","M5417","F1029","L603","E1140","M9900","M9901","M9902","M5451","E785","D649","R079","I499","E8342","M5450","R52","Z0101","Z87891","R0789","R6889","I6529","Z89412","E11621","L97521","L089","L600","T8131XD","F32A","D485","L97529","G8929","M51360","R0600","L03031","J683","H40053","B9689","R21","M160","E118","G629","R0602","Z8631","T8133XD"],"date":["2025-03-11","2025-10-28","2023-05-12","2023-05-12","2023-05-12","2025-09-30","2025-10-02","2025-03-06","2023-09-08","2025-11-14","2023-07-25","2023-06-28","2025-02-25","2025-10-02","2025-10-02","2025-10-02","2025-02-24","2025-02-25","2025-09-09","2025-07-23","2025-04-30","2025-02-26","2025-10-02","2025-10-29","2025-11-14","2024-05-29","2025-10-01","2025-03-28","2025-11-12","2025-11-12","2025-11-12","2025-09-09","2025-09-09","2025-09-30","2025-09-30","2025-10-28","2025-10-28","2025-10-28","2025-10-28","2025-07-08","2025-04-29","2025-03-28","2025-04-29","2025-04-29","2025-07-22","2023-04-17","2025-08-11","2025-10-02","2025-03-11","2023-12-13","2023-12-27","2025-11-14","2025-11-14","2025-10-27","2025-09-15","2025-09-15","2025-10-13","2024-05-29","2024-10-10","2025-11-14","2025-07-23","2025-07-23","2023-03-08","2025-09-12","2023-03-08","2023-01-24","2025-09-12","2024-06-06","2023-04-17","2025-10-29","2025-10-29","2025-03-11","2025-10-31","2025-10-31"],"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":[["","","OXYCODONE HCL","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","NALTREXONE HCL","","","Select","Select",""],["","","PAROXETINE HCL","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","EC-NAPROXEN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","ADVAIR DISKUS","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","NAPROXEN","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","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":{"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":""}]}]}