{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Abraham J Drost","gend":0,"currentgend":"","add":"24 WOODMAN ST","city":"WASHBURN","state":"ME","zip":"04786","dob":"1951-09-06","age":"","mstatus":"","insh":"10000091577","cliId":"","pno":"2075540061","cno":"2075540061","email":"ajohndrost@gmail.com","ename":"","eno":"","pphy":"ARMSTRONG, JOHN R","ppno":"2074982356","pcpadd":"Pines Health Services,74 Access Hwy","pcpcity":"Caribou","pcpstate":"ME","pcpzip":"04736","pcpcounty":"","pcpid":"","pcpname":"PINES CARIBOU HEALTH CENTER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"P O BOX 422","madd2":"","madd3":"","mcity":"WASHBURN","mstate":"ME","mzip":"04786","pcpfaxno":"2074937725","pcpnpi":"1952893406","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5AV0KJ0VF09","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C3431","D649","K219","Z452","E119","H25813","H353131","H5703","H532","R1110","D61818","E1136","H25811","H2181","Z48810","K2970","K449","R112","Z79899","K319","K2100","K2950","R5383","Z902","Z9221","Z923","I6523","J449","R42","N289","I10","Z98890","I639","R079","I25118","R55","Z8673","I252","I428","R0683","Z95828","H25812","H3554","Z961","I083","I5189","G4700","I340","C3490","I255","Z09","F17210","Z0000","R0609","I6502","I69354","J869","R110","I6389","I6521","Z85118"],"date":["2026-03-02","2023-04-13","2023-07-18","2026-02-09","2026-03-02","2023-06-30","2025-01-24","2023-07-26","2023-06-30","2024-03-27","2023-09-12","2023-07-26","2023-07-26","2023-07-26","2023-09-01","2023-08-03","2023-08-03","2023-08-03","2023-08-03","2023-08-03","2023-08-03","2023-09-12","2024-11-12","2025-12-15","2023-09-27","2023-09-27","2026-03-03","2025-07-17","2024-02-28","2024-01-31","2024-02-26","2024-03-01","2024-03-20","2024-02-05","2025-09-16","2024-02-12","2024-02-12","2024-02-12","2024-04-26","2025-01-23","2025-12-15","2025-09-23","2025-09-23","2025-09-23","2025-09-29","2025-10-21","2025-01-09","2024-07-18","2025-09-08","2024-12-17","2024-12-16","2025-01-23","2026-03-02","2024-11-12","2026-03-03","2023-01-29","2023-02-09","2023-02-09","2023-02-09","2023-02-16","2023-02-16"],"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":[["","","FLUTICASONE PROP","50 MCG","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Sandoz","","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","MNEXSPIKE","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE","30 MG","","Select","Select",""],["","","TAMSULOSIN","0.4 MG","","Select","Select",""],["","","FLUZONE HIGH-DOSE","","","Select","Select",""],["","","SPIRONOLACTONE","25 MG","","Select","Select",""],["","","ROSUVASTATIN","40 MG","","Select","Select",""],["","","SACUBITRIL\/VALSARTAN","24\/26 MG","","Select","Select",""],["","","ENTRESTO","","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","OMEPRAZOLE","20 MG","","Select","Select",""],["","","ANORO ELLIPTA","","","Select","Select",""],["","","Fluzone High-Dose Quad 2023-24","","","Select","Select",""],["","","LORAZEPAM","1 MG","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","Moxifloxacin 0.5 % Ophth Sol Apotex","","","Select","Select",""],["","","ATENOLOL","25 MG","","Select","Select",""],["","","Ketorolac 0.5 % Ophth Sol Apotex","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD","","","Select","Select",""],["","","MOXIFLOXACIN","0.005","","Select","Select",""],["","","PREDNISOLONE ACE","0.01","","Select","Select",""],["","","KETOROLAC","0.005","","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":""}]}]}