{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ludger J Tremblay","gend":0,"currentgend":"","add":"69 BARROWS DR","city":"Topsham","state":"ME","zip":"04086","dob":"1950-05-19","age":"","mstatus":"","insh":"10000040442","cliId":"","pno":"2077293597","cno":"2075047654","email":"ludgert1950@gmail.com","ename":"","eno":"","pphy":"PARRIS, KRISTIN H","ppno":"2074067600","pcpadd":"301C US ROUTE 1,","pcpcity":"SCARBOROUGH","pcpstate":"ME","pcpzip":"40749701","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"69 BARROWS DR","madd2":"","madd3":"","mcity":"Topsham","mstate":"ME","mzip":"04086","pcpfaxno":"2073968632","pcpnpi":"1386632289","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1FX7HG6KN56","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E1140","L852","R262","B351","M79674","M79675","K760","E1165","R4589","R45851","Z125","Z0000","E11319","Z794","I2510","I2584","F419","F32A","Z0101","E113293","H43821","H3561","H5203","H52223","H524","F332","Z20822","I10","E119","H3560","Z87898","I6521","D494","R9720","N400","F4323","H35363","H35372","Z8551","N3289","C680","R748","Z9049","N281","R7401","R6889","H43813","M5450","M47816","I700","G8929","N200","N2889","K5790","C679","Z1211","Z86010","K635","K5730","K8689","K861","R0989","Z48812","G7249","Z79899","T466X5A","M6281","Z01818","J90","R109","R29898","R930","R9089","R519","M609","M6089","J9811","R079","R531","M4804","I214","Z13820","R7989","I252","R634","K219","C61","M79606","W19XXXA","E782","Z09","Z951","Z01810","I6523","Z8042","C678","F418","E785","K838","N401","D090","M79601","M722","M24571","M79671","R4182","I371","R931","Z7409","Z743","Z4689","K5900","M3320","E113299","K769","I959","M47812","M4802","C672","H6123","H9313","I951","F325","K862","A000","I358","I5030","M4727","M5117","S0990XA","R932","D123","D120","S199XXA","L608","R21"],"date":["2023-04-12","2023-04-12","2026-02-05","2026-02-05","2023-11-20","2023-11-20","2025-11-20","2023-05-01","2023-05-06","2023-05-06","2023-05-01","2025-05-12","2023-05-04","2025-12-30","2025-06-05","2025-06-03","2023-11-06","2023-08-03","2025-04-22","2025-12-30","2023-06-22","2023-11-07","2025-04-22","2025-04-22","2025-04-22","2023-05-09","2023-05-06","2025-06-22","2025-05-31","2023-05-24","2026-01-23","2023-05-24","2025-04-17","2025-04-16","2023-11-08","2023-08-31","2023-06-22","2023-06-22","2024-10-29","2024-07-22","2023-11-08","2025-12-06","2023-11-27","2025-12-04","2025-12-12","2023-05-22","2024-03-21","2026-02-03","2025-03-10","2025-06-22","2025-09-16","2025-11-25","2024-04-30","2024-04-30","2025-04-28","2024-07-05","2024-07-05","2024-07-05","2024-07-05","2024-12-09","2025-09-25","2025-06-22","2025-06-13","2026-02-20","2026-02-20","2026-02-20","2025-12-06","2025-06-03","2025-06-22","2024-11-06","2025-12-06","2025-12-05","2025-12-05","2025-12-05","2026-02-20","2025-12-05","2025-06-22","2025-12-04","2025-12-04","2025-12-04","2025-11-03","2026-01-23","2025-12-02","2025-07-10","2025-12-12","2024-12-09","2025-11-25","2025-12-04","2025-12-04","2025-06-25","2025-06-06","2025-07-02","2025-06-03","2025-06-03","2024-10-29","2025-11-25","2025-04-28","2025-06-05","2024-12-09","2025-11-25","2024-07-22","2025-06-22","2026-02-05","2026-02-05","2026-02-05","2025-06-05","2025-06-05","2025-06-02","2025-06-12","2025-06-02","2024-12-09","2025-12-12","2025-12-12","2024-08-07","2024-11-06","2025-06-11","2025-12-04","2025-12-04","2024-07-22","2025-02-07","2025-02-07","2025-06-25","2025-06-25","2026-01-06","2025-06-13","2025-06-01","2025-06-01","2025-11-17","2025-11-17","2025-12-04","2024-06-26","2024-07-05","2024-07-05","2025-12-04","2023-03-16","2023-03-16"],"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":[["","","UNIFINE PENTIPS MINI","","","Select","Select",""],["","","GLIMEPIRIDE","2 MG","","Select","Select",""],["","","MIRTAZAPINE","7.5 MG","","Select","Select",""],["","","FREESTYLE LITE","","","Select","Select",""],["","","METFORMIN","500 MG","","Select","Select",""],["","","LISINOPRIL","5 MG","","Select","Select",""],["","","Rybelsus (Formulation R1)","","","Select","Select",""],["","","TRAMADOL","50 MG","","Select","Select",""],["","","ATORVASTATIN","10 MG","","Select","Select",""],["","","Pantoprazole","40 MG","","Select","Select",""],["","","CREON","","","Select","Select",""],["","","Clotrim\/Betameth Diprop 1\/0.05 % Cream Fou","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","100 MG","","Select","Select",""],["","","EPINEPHRINE","0.3 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","FREESTYLE","","","Select","Select",""],["","","OMEPRAZOLE","40 MG","","Select","Select",""],["","","NITROGLYCERIN","0.4 MG","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","BD ULTRA-FINE MICRO","","","Select","Select",""],["","","INSULIN GLARGINE-YFGN","","","Select","Select",""],["","","CAREONE UNIFINE PENTIPS PLUS MINI","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","Bd Ultra-Fine Mini (Ref 320119)","","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","PREGABALIN","25 MG","","Select","Select",""],["","","Embecta Ultra-Fine (Ref 320119)","","","Select","Select",""],["","","CLOPIDOGREL","75 MG","","Select","Select",""],["","","Freestyle Insulinx (Ref 71231-70)","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","GABAPENTIN","100 MG","","Select","Select",""],["","","BASAGLAR KWIKPEN","","","Select","Select",""],["","","Insulin Glargine 100 Units\/Ml Inj (Pen) Wi","","","Select","Select",""],["","","LORAZEPAM","0.5 MG","","Select","Select",""],["","","Econazole 1 % Cream Perrigo","","","Select","Select",""],["","","Freestyle Libre 3 Sensor","","","Select","Select",""],["","","METOPROLOL SUCC","25 MG","","Select","Select",""],["","","Freestyle Libre 3 Reader","","","Select","Select",""],["","","CIPROFLOXACIN","500 MG","","Select","Select",""],["","","Neo\/Polymyx\/Hydrocortisone 3.5\/10","","","Select","Select",""],["","","BD ULTRA-FINE MINI (REF","","","Select","Select",""],["","","RYBELSUS (FORMULATION R","","","Select","Select",""],["","","INSULIN GLARGINE","100 UNITS\/ML","","Select","Select",""],["","","EMBECTA ULTRA-FINE (REF","","","Select","Select",""],["","","NEO\/POLYMYX\/HYDROCORTISONE","","","Select","Select",""],["","","FREESTYLE INSULINX (REF","","","Select","Select",""],["","","FREESTYLE LIBRE","","","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":""}]}]}