{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jason M Horr","gend":0,"currentgend":"","add":"85 THOMAS POND TERRACE RD","city":"RAYMOND","state":"ME","zip":"04071","dob":"1974-03-09","age":"","mstatus":"","insh":"10000083116","cliId":"","pno":"2078317804","cno":"","email":"gzjaz@yahoo.com","ename":"","eno":"","pphy":"CAREY, SEAN P","ppno":"2078392559","pcpadd":"Martins Point Health Care,575 Main St","pcpcity":"Gorham","pcpstate":"ME","pcpzip":"04038","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"85 THOMAS POND TERRACE RD","madd2":"","madd3":"","mcity":"RAYMOND","mstate":"ME","mzip":"04071","pcpfaxno":"2075231135","pcpnpi":"1447328125","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7JQ8X65YC52","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":["E11621","L84","L97529","F411","F331","F422","Z8631","F330","E1165","E1140","E039","E785","E11319","Z794","F482","R41844","G4733","G4730","H524","H5213","Z1211","F418","I10","K219","K635","K5730","I2510","D120","D122","D125","F441","F333","M19012","M79622","S4992XD","L089","S46212A","R079","I319","R509","Z87891","I3481","I5A","I309","I69351","Z6843","E119","Z23","S46011A","S46012A","M75102","S43003A","M25512","R2241","I6931","F902","I872","N481","Z125","S46002D","M7989","G8929","B351","E1149","L97521","L851","M79675","L03032","Z20822","R059","J189","R053","Z8673","Z01818","R4182","Z713","E66813","Z6842","N471","N480","N4883","E6601","E782","E1169","E559","Z5189","Z6841","I6523","G4762","K589","Z9884","F39","M5450","S39012A","K760","I2720","Z4889","J45909","T148XXA","R7989","S3992XA","M47816","Z980","Z6839","L97522","J209","Z09"],"date":["2024-06-25","2024-04-30","2024-06-25","2026-03-09","2026-03-09","2023-05-29","2023-04-25","2025-04-09","2025-09-18","2024-05-31","2025-09-18","2026-01-13","2025-09-30","2025-11-24","2026-03-09","2023-11-06","2025-05-06","2023-07-19","2025-09-30","2025-09-30","2023-08-09","2025-03-12","2025-11-24","2025-03-12","2023-08-09","2023-08-09","2025-09-09","2025-03-12","2025-03-12","2023-08-09","2023-09-25","2023-09-25","2023-10-02","2023-10-02","2023-10-04","2023-10-04","2024-01-10","2024-06-29","2025-04-18","2023-10-10","2023-10-02","2023-10-10","2023-10-12","2023-10-10","2023-10-10","2025-07-09","2025-11-24","2025-09-23","2023-10-19","2023-10-19","2023-12-06","2023-12-06","2024-04-24","2023-10-09","2023-11-06","2023-11-06","2024-05-07","2025-12-16","2025-09-18","2024-04-29","2024-04-23","2024-04-24","2024-05-08","2024-05-08","2024-05-08","2024-05-08","2024-05-05","2024-05-05","2024-05-09","2024-06-29","2025-06-07","2024-06-04","2024-06-18","2025-03-12","2025-03-12","2025-10-08","2026-01-13","2025-08-13","2026-03-06","2026-03-06","2026-03-06","2025-07-09","2024-12-18","2024-12-31","2024-11-06","2025-08-22","2025-02-20","2025-01-08","2025-01-07","2025-01-07","2025-12-16","2025-07-17","2025-05-09","2024-09-06","2025-07-03","2025-04-18","2025-07-24","2025-07-09","2025-05-03","2025-09-18","2025-05-09","2025-05-09","2026-01-13","2026-01-13","2023-03-07","2023-02-03","2023-01-31"],"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":[["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","FLUCONAZOLE","150 MG","","Select","Select",""],["","","Bd Nano 2 Gen","","","Select","Select",""],["","","Accu-Chek Guide","","","Select","Select",""],["","","CYCLOBENZAPRINE","5 MG","","Select","Select",""],["","","Accu-Chek Guide Me","","","Select","Select",""],["","","COLCHICINE","0.6 MG","","Select","Select",""],["","","Clotrim\/Betameth Diprop 1\/0.05 % Cream Fou","","","Select","Select",""],["","","TRAZODONE","50 MG","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","100 MG","","Select","Select",""],["","","ALBUTEROL\/IPRATROPIUM","3\/0.5 MG\/3","","Select","Select",""],["","","DIVALPROEX","500 MG","","Select","Select",""],["","","EZETIMIBE","10 MG","","Select","Select",""],["","","TERBINAFINE","250 MG","","Select","Select",""],["","","LEVOTHYROXINE","125 MCG","","Select","Select",""],["","","Clotrimazole 1 % Cream Taro","","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","ROSUVASTATIN","20 MG","","Select","Select",""],["","","Flulaval Trivalent 2024-2025","","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","MELOXICAM","7.5 MG","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","ONDANSETRON","4 MG","","Select","Select",""],["","","OLMESARTAN","20 MG","","Select","Select",""],["","","Bd Ultra-Fine Mini (Ref 320119)","","","Select","Select",""],["","","OMEPRAZOLE","20 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","Accu-Chek Softclix","","","Select","Select",""],["","","FAMOTIDINE","20 MG","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","Insulin Glargine U-300 Solostar","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","BASAGLAR KWIKPEN","","","Select","Select",""],["","","Dexcom G7 Sensor","","","Select","Select",""],["","","FLUTICASONE PROP\/SALMETEROL","250\/50 MCG","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","Flucelvax Quad 2023-2024","","","Select","Select",""],["","","WIXELA INHUB","","","Select","Select",""],["","","TOUJEO SOLOSTAR","","","Select","Select",""],["","","ESCITALOPRAM","20 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","INSULIN ASPART FLEXPEN","","","Select","Select",""],["","","Nystatin 100","","","Select","Select",""],["","","BD ULTRA-FINE MINI (REF","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","DEXCOM G","","","Select","Select",""],["","","FLULAVAL TRIVALENT","","","Select","Select",""],["","","BD NANO","","","Select","Select",""],["","","CLOTRIMAZOLE","0.01","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","INSULIN GLARGINE U-","","","Select","Select",""],["","","FLUCELVAX QUAD","","","Select","Select",""],["","","CLOTRIM\/BETAMETH DIPROP","1\/0.05 %","","Select","Select",""],["","","FLUTICASONE PROP","50 MCG","","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":""}]}]}