{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Bernard A Caron","gend":0,"currentgend":"","add":"44 PARKSIDE DR","city":"BIDDEFORD","state":"ME","zip":"04005","dob":"1951-01-10","age":"","mstatus":"","insh":"10000047424","cliId":"","pno":"2074685244","cno":"","email":"fcaronbr@gmail.com","ename":"","eno":"","pphy":"CUTONE, STEVEN R","ppno":"","pcpadd":"1 MEDICAL CENTER DR,P.O. BOX 626","pcpcity":"BIDDEFORD","pcpstate":"ME","pcpzip":"40059422","pcpcounty":"","pcpid":"","pcpname":"INTERNAL MEDICINE OF SOUTHERN MAINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 1963","madd2":"","madd3":"","mcity":"BIDDEFORD","mstate":"ME","mzip":"04005","pcpfaxno":"2072829180","pcpnpi":"1831152743","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5K88P04PY46","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L821","C44311","L570","K5790","E7800","R4182","Z136","H04123","D225","D492","L578","L814","Z85828","I776","H532","E785","M5416","M7601","H903","G7000","H9190","H547","M25559","R635","M2550","J069","R42","K769","K7689","H8110","I10","Z125","Z0000","L820","R208","M79604","I8001","I82811","M25571","G8929","Z1211","D122","K5730","K648","I6523","R9720","M76891","M79671","M67813","M19071","R5383","M25551","M5137","M47817","R0602","R0600","R0609","R0989","M810","Z9189","I2510","M8589","G7001","Z801","M6281","H5203","R7301","I8391","M5450"],"date":["2024-06-07","2023-04-28","2024-06-07","2023-04-28","2023-04-28","2023-04-28","2023-06-02","2023-06-05","2024-06-07","2023-06-23","2023-06-23","2024-06-07","2024-06-07","2023-07-21","2023-10-17","2026-02-01","2023-11-22","2023-11-22","2025-05-07","2026-02-11","2024-03-13","2026-02-01","2026-02-01","2026-02-01","2023-12-21","2024-02-24","2024-03-13","2024-03-05","2024-03-28","2024-03-25","2024-04-05","2025-04-04","2024-04-05","2024-06-07","2024-06-07","2024-08-26","2024-09-20","2024-08-26","2025-09-11","2025-09-02","2024-09-24","2024-09-24","2024-09-24","2024-09-24","2025-11-24","2025-09-04","2025-09-11","2025-09-29","2025-09-29","2025-09-29","2026-02-26","2023-03-24","2023-03-24","2023-03-24","2026-02-26","2025-11-19","2025-11-19","2025-11-19","2025-06-27","2026-02-26","2026-02-26","2025-06-27","2025-11-19","2026-01-19","2025-04-11","2025-04-15","2023-02-28","2023-03-17","2023-03-17"],"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",""],["","","PYRIDOSTIGMINE","60 MG","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","MECLIZINE","25 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","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":""}]}]}