{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Robert E Duprey","gend":0,"currentgend":"","add":"43 ACADEMY ST APT 5","city":"PRESQUE ISLE","state":"ME","zip":"04769","dob":"1943-04-28","age":"","mstatus":"","insh":"10000008249","cliId":"","pno":"2072549005","cno":"","email":"ACBDUPREY@GMAIL.COM","ename":"","eno":"","pphy":"FLYNN, CARL E","ppno":"","pcpadd":"PO BOX 40,","pcpcity":"CARIBOU","pcpstate":"ME","pcpzip":"47360040","pcpcounty":"","pcpid":"","pcpname":"PINES CARIBOU HEALTH CENTER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"43 ACADEMY ST APT 5","madd2":"","madd3":"","mcity":"PRESQUE ISLE","mstate":"ME","mzip":"04769","pcpfaxno":"2074983947","pcpnpi":"1609844422","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2RQ4R42TV77","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I480","Z7901","I351","I6789","M5416","E7800","H25813","H53461","H40012","H33302","H25811","Z01818","H2181","Z48810","R6889","H25812","H5703","Z23","Z0001","R9720","Z125","H538","Z87891","Z961"],"date":["2024-05-02","2023-05-01","2023-07-25","2023-05-01","2023-10-30","2023-10-30","2023-06-14","2023-09-12","2023-06-14","2023-06-14","2023-07-25","2023-08-30","2023-09-12","2023-10-23","2023-03-04","2023-09-12","2023-09-12","2023-10-30","2024-05-10","2023-11-01","2023-11-01","2023-11-13","2023-11-13","2023-12-05"],"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":[["","","Atorvastatin","20 MG","","Select","Select",""],["","","Alfuzosin","10 MG","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Sandoz","","","Select","Select",""],["","","Ketoconazole 2 % Cream Fougera","","","Select","Select",""],["","","Ketorolac 0.4 % Ophth Sol Pacific","","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Fluzone High Dose","","","Select","Select",""],["","","Arexvy","","","Select","Select",""],["","","Clotrimazole 1 % Cream Taro","","","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":""}]}]}