{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Paul T Flohr","gend":0,"currentgend":"","add":"924 BRIDGTON RD","city":"WESTBROOK","state":"ME","zip":"04092","dob":"1946-07-28","age":"","mstatus":"","insh":"10000053433","cliId":"","pno":"2076235547","cno":"2076235547","email":"Declined@09052024.com","ename":"","eno":"","pphy":"LITTLE, KASEY R","ppno":"2077745816","pcpadd":"InterMed,84 Marginal Way Ste 800","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04101","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"924 BRIDGTON RD","madd2":"","madd3":"","mcity":"WESTBROOK","mstate":"ME","mzip":"04092","pcpfaxno":"2078741483","pcpnpi":"1720441595","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6R44KN8HH09","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H2513","H35363","H52213","G894","M48062","M5450","M792","E1121","H2512","H2511","M5441","M5116","M4726","H26493","M4807","M5117","M4727","R5382","E1136","Z23","Z0000","Z0001","R053","Z7984","E538","H16223","H02831","M19011","M75101","M25511","H02403","Z0101","H02833","H02836","M797","M7541","J069","E1165","Z713","S0501XA","S0502XA","E1122","E1169","E1159","H169","Z87891","R61","D801","E7800","D3131","E119","Z794","R413","H3530","H43813","H40013","N1831","E559","I10","I6782","H539","Z79899","F4323","M48061","E11649","R634","J8410","M5431","M79604","E1142","M79602","M25561","M47816","M2578","M25461"],"date":["2023-04-05","2024-02-20","2023-04-05","2025-07-25","2023-05-10","2023-06-15","2023-10-26","2023-11-22","2023-08-17","2023-08-31","2023-10-26","2025-02-03","2023-09-20","2024-01-11","2023-10-21","2025-02-03","2025-02-03","2023-10-26","2024-03-12","2026-02-04","2025-02-25","2026-01-12","2023-11-29","2024-11-27","2024-03-12","2024-03-25","2024-02-29","2024-04-03","2024-04-03","2024-05-23","2024-04-03","2024-03-25","2024-03-25","2024-03-25","2024-05-15","2024-05-23","2024-05-20","2026-02-04","2025-03-06","2025-03-14","2025-03-14","2026-02-04","2025-07-11","2026-02-04","2025-04-18","2025-03-14","2026-01-12","2026-01-12","2025-09-19","2026-02-26","2026-02-26","2025-09-03","2026-01-05","2026-01-02","2026-02-26","2026-02-26","2025-12-31","2025-12-31","2025-02-25","2026-01-05","2025-10-07","2025-07-25","2025-05-29","2025-02-03","2026-02-04","2026-01-30","2026-01-30","2025-02-03","2025-02-03","2025-07-11","2023-03-08","2023-02-13","2023-02-13","2023-02-13","2023-02-13"],"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":[["","","Bd Nano 2 Gen","","","Select","Select",""],["","","LISINOPRIL","5 MG","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Sandoz","","","Select","Select",""],["","","Embecta Nano 2Nd Gen (Ref 320550)","","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","Freestyle Libre 3 Sensor Plus","","","Select","Select",""],["","","ROSUVASTATIN","10 MG","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","7.5\/325 MG","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","DULOXETINE","30 MG","","Select","Select",""],["","","GLIPIZIDE","5 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","PREGABALIN","225 MG","","Select","Select",""],["","","Moxifloxacin 0.5 % Ophth Sol Aurobindo","","","Select","Select",""],["","","Fluorometholone 0.1 % Ophth Susp Pacific","","","Select","Select",""],["","","Erythromycin 0.5 % Ophth Oint B&L","","","Select","Select",""],["","","BASAGLAR KWIKPEN","","","Select","Select",""],["","","Ketorolac 0.5 % Ophth Sol Apotex","","","Select","Select",""],["","","Betamethasone Diprop 0.05 % Cream Taro","","","Select","Select",""],["","","Dexcom G7 Receiver (Ref Stk-At-012)","","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","Freestyle Libre 3 Sensor","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","Freestyle Libre 3 Reader","","","Select","Select",""],["","","FREESTYLE","","","Select","Select",""],["","","VALACYCLOVIR","1 GM","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","CAREONE UNIFINE PENTIPS PLUS","","","Select","Select",""],["","","KETOROLAC","0.005","","Select","Select",""],["","","MOXIFLOXACIN","0.005","","Select","Select",""],["","","BETAMETHASONE DIPROP","0.0005","","Select","Select",""],["","","DEXCOM G","7 RECEIVER","","Select","Select",""],["","","BD NANO","","","Select","Select",""],["","","PREDNISOLONE ACE","0.01","","Select","Select",""],["","","ERYTHROMYCIN","0.005","","Select","Select",""],["","","FLUOROMETHOLONE","0.001","","Select","Select",""],["","","FREESTYLE LIBRE","3 SENSOR","","Select","Select",""],["","","EMBECTA NANO","2ND GEN","","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":""}]}]}