{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Peter J Stewart","gend":0,"currentgend":"","add":"98 FISH CREEK ROAD","city":"Deer Isle","state":"ME","zip":"04627","dob":"1946-11-17","age":"","mstatus":"","insh":"10000013617","cliId":"","pno":2073489927,"cno":2073489963,"email":"stewartdowneast@gmail.com","ename":"","eno":"","pphy":"NIGHTINGALE, STEPHEN H","ppno":2074697371,"pcpadd":"33 Seaveys Way Ste 2,","pcpcity":"Ellsworth","pcpstate":"ME","pcpzip":"04605","pcpcounty":"","pcpid":"","pcpname":"BUCKSPORT REGIONAL HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"39 LOWE RD","madd2":"","madd3":"","mcity":"Deer Isle","mstate":"ME","mzip":"04627","pcpfaxno":2074697306,"pcpnpi":1538140520,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4MV9TD8YQ56","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H35073","H35363","H34823","Z01818","C61","Z87891","Q600","N200","H26491","E785","R7301","R9720","Z0000","L570","D485","L821","L578","N281","R6889","H401131","H353131","H43393","H538","L820","R5383","W57XXXA","R768","R109","R000","Z23","N400","E782","H26493","L989","N4289","D045","Z510","H35433","L905","D1801","K5730","K4090","R9721"],"date":["2024-01-15","2024-01-15","2024-01-15","2025-06-03","2025-09-05","2025-06-05","2025-06-05","2025-06-12","2023-06-16","2022-11-01","2022-11-01","2024-10-22","2025-07-25","2025-01-03","2025-01-03","2025-01-03","2025-01-03","2025-04-03","2022-11-28","2025-07-01","2025-07-01","2025-07-01","2025-07-01","2025-01-03","2023-07-13","2023-07-13","2023-07-25","2025-05-01","2023-07-24","2023-12-11","2025-06-12","2025-06-12","2025-01-07","2024-09-16","2024-07-23","2023-01-12","2025-03-12","2023-01-13","2023-12-29","2024-09-09","2023-05-13","2023-05-13","2025-02-04"],"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":[["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","ORGOVYX","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","TRAMADOL HCL","","","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":""}]}]}