{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Robert C Stewart","gend":0,"currentgend":"","add":"122 KING RD","city":"Lisbon","state":"ME","zip":"04250","dob":"1946-10-16","age":"","mstatus":"","insh":"10000022472","cliId":"","pno":2073537403,"cno":"","email":"declined@012025.com","ename":"","eno":"","pphy":"BEGGS, ALEX W","ppno":2077955700,"pcpadd":"12 HIGH ST,","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42407676","pcpcounty":"","pcpid":"","pcpname":"CENTRAL MAINE INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 347","madd2":"","madd3":"","mcity":"Lisbon","mstate":"ME","mzip":"04250","pcpfaxno":2077955727,"pcpnpi":1750862769,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5N81HE2EU32","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L814","L821","Z08","Z85828","L570","X32XXXA","B351","M79675","M79674","R262","Z7901","E1142","Z0000","I10","E1122","I480","I2510","R809","I4892","Z1211","D128","D122","Z86010","I4821","Z951","I5020","S79911A","R001","R269","S0990XA","I455","R55","R9082","Z043","M546","R109","I130","R339","R410","Z7189","S0081XA","W06XXXA"],"date":["2024-10-10","2024-10-10","2024-10-10","2024-10-10","2024-10-10","2024-10-10","2025-08-18","2025-08-18","2025-08-18","2025-01-20","2025-09-30","2025-08-18","2024-06-13","2025-10-13","2025-04-11","2025-11-01","2025-05-23","2024-01-05","2025-05-23","2023-04-11","2023-04-11","2023-04-11","2023-04-11","2025-10-10","2024-02-08","2025-10-28","2025-09-14","2025-10-01","2025-09-16","2023-10-14","2025-09-15","2025-09-14","2023-10-14","2025-09-14","2025-09-14","2025-09-14","2025-09-17","2025-10-28","2025-10-27","2024-06-13","2023-10-14","2023-10-14"],"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":[["","","SACUBITRIL-VALSARTAN","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","LATANOPROST","","","Select","Select",""],["","","DORZOLAMIDE-TIMOLOL","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","JANTOVEN","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","OLMESARTAN MEDOXOMIL","","","Select","Select",""],["","","WARFARIN SODIUM","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","GAVILYTE-G","","","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":{"indx":[],"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":""}]}]}