{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Armand D Bouchard","gend":0,"currentgend":"","add":"159 TONDREAUS POINT RD","city":"Harpswell","state":"ME","zip":"04079","dob":"1939-04-06","age":"","mstatus":"","insh":"10000028419","cliId":"","pno":"2077984718","cno":"","email":"armandbouchard@comcast.net","ename":"","eno":"","pphy":"SOMMER, JOHN E","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 - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"159 TONDREAUS POINT RD","madd2":"","madd3":"","mcity":"Harpswell","mstate":"ME","mzip":"04079","pcpfaxno":"2078287850","pcpnpi":"1275732364","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9KH8WN8ET58","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B351","M79674","M79675","F411","N400","I639","D500","K921","M6281","R9089","R29818","R531","R404","I361","I517","N200","K5790","K5900","I2510","I6523","I672","I6501","K9289","G459","R410","R1110","K254","K920","K449","K2289","K922","G9340","R29810","K219","E119","F418","D649","D509","K2100","F0390","F331","L858","C44629","F329","L989","R102","S3993XA","M47816","M160","R6889","R279","R600","R159","M533","W06XXXA","G218","G20C","R4189","M810","M25439","M25431","M7989","R9402","H6123","E113293","Z0101","G20A1","S72001D","S72141A","S72001A","G2401","I615","K625","W19XXXA","H93293","R0902","M1711","R609","S066XAA","R569","E785","I609","L570","D229","L821","L814","L578","S06360A","R55","Z23","B354","E1122","N189","I499","I629","H903","S72143D","I739","E611","S066X0A","A000","N401","G3184","R000","R918","R0989","R059","G4089","F333","F339","R4182"],"date":["2025-12-01","2025-12-01","2025-12-01","2023-09-11","2025-04-22","2023-05-11","2023-05-11","2023-05-10","2023-05-10","2023-05-08","2023-05-08","2026-01-13","2023-05-11","2023-05-09","2023-05-09","2023-05-08","2023-05-08","2026-02-04","2023-05-08","2023-05-08","2023-05-08","2023-05-08","2023-05-18","2023-05-10","2025-07-29","2023-05-08","2023-05-19","2023-05-10","2023-05-10","2023-05-10","2023-05-10","2023-05-10","2023-05-10","2023-05-10","2026-01-21","2023-05-10","2026-01-14","2025-12-17","2023-08-14","2026-01-28","2025-11-06","2023-08-02","2023-08-23","2023-08-21","2023-08-23","2023-12-01","2023-10-23","2026-01-12","2026-01-14","2023-12-19","2024-01-23","2024-01-23","2024-01-23","2024-01-23","2024-01-23","2026-01-21","2024-09-03","2024-02-16","2024-03-21","2024-03-21","2024-03-21","2024-03-21","2024-04-03","2024-08-19","2024-05-21","2025-08-04","2024-06-14","2026-02-16","2026-01-14","2026-02-11","2026-02-04","2025-08-06","2024-07-23","2026-01-14","2024-08-19","2026-01-23","2026-01-24","2026-01-24","2025-07-25","2026-01-14","2026-01-14","2025-08-06","2025-01-09","2025-01-09","2025-01-09","2025-01-09","2025-01-09","2025-07-25","2025-07-25","2025-12-23","2025-07-21","2025-07-29","2025-07-29","2026-03-07","2025-07-29","2025-07-02","2026-01-14","2026-01-14","2026-01-28","2025-07-25","2023-02-25","2023-03-07","2023-03-07","2023-02-20","2023-02-20","2023-02-20","2023-02-20","2023-02-20","2023-02-22","2023-02-20","2023-02-20"],"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":[["","","FLURBIPROFEN","100 MG","","Select","Select",""],["","","METFORMIN","500 MG","","Select","Select",""],["","","ATORVASTATIN","10 MG","","Select","Select",""],["","","ARIPIPRAZOLE","15 MG","","Select","Select",""],["","","PENICILLIN VK","500 MG","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","AUSTEDO","","","Select","Select",""],["","","ALENDRONATE","70 MG","","Select","Select",""],["","","PAXLOVID","300\/100 MG","","Select","Select",""],["","","TAMSULOSIN","0.4 MG","","Select","Select",""],["","","VENLAFAXINE","150 MG","","Select","Select",""],["","","FLUCONAZOLE","200 MG","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","MELOXICAM","7.5 MG","","Select","Select",""],["","","TRAMADOL","50 MG","","Select","Select",""],["","","QUETIAPINE","25 MG","","Select","Select",""],["","","TROSPIUM","20 MG","","Select","Select",""],["","","Carbidopa\/Levodopa","25\/100 MG","","Select","Select",""],["","","BOOSTRIX","","","Select","Select",""],["","","Fluzone High-Dose Quad 2023-24","","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","ESCITALOPRAM","10 MG","","Select","Select",""],["","","CARBIDOPA-LEVODOPA","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD","","","Select","Select",""],["","","SPIKEVAX","","","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":""}]}]}