{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"David J Zuk","gend":0,"currentgend":"","add":"58 SCHOOL ST","city":"ELLSWORTH","state":"ME","zip":"04605","dob":"1951-07-13","age":"","mstatus":"","insh":"10000049365","cliId":"","pno":2076672345,"cno":"","email":"davidjzuk@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":2079079474,"add2":"","add3":"","madd1":"58 SCHOOL ST","madd2":"","madd3":"","mcity":"ELLSWORTH","mstate":"ME","mzip":"04605","pcpfaxno":2074697306,"pcpnpi":1538140520,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3J13YM8GM89","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J029","E871","R198","H903","H9313","R3129","D509","Z125","E782","Z0000","G4733","G5603","R202","M11261","R002","I10","H26492","H04123","R519","H01022","I498","J320","J322","J370","K219","R310","I351","D126","M1711","F1021","G43709","H52533","H5712","D23122","H02825","L02212","K529","R55","H26493","H01025","H35413","J331","D649","M2560","M159","M25561","M6281"],"date":["2023-12-26","2025-04-08","2024-02-28","2025-05-20","2025-04-18","2025-04-08","2025-04-08","2025-04-08","2025-04-08","2025-04-07","2025-08-18","2023-09-27","2023-08-08","2025-08-25","2024-10-13","2025-04-08","2024-02-27","2024-01-17","2024-01-17","2024-01-17","2024-08-28","2025-02-24","2025-02-24","2025-02-24","2025-02-24","2024-08-09","2024-11-08","2025-04-10","2023-04-19","2024-09-26","2024-09-26","2024-10-30","2024-10-30","2024-05-21","2024-05-21","2024-06-11","2024-03-29","2024-06-13","2023-01-13","2023-01-13","2023-01-13","2022-10-20","2023-02-27","2023-02-27","2023-03-07","2022-08-19","2022-08-19"],"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":[["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","VERAPAMIL ER","","","Select","Select",""],["","","SUMATRIPTAN SUCCINATE","","","Select","Select",""],["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","VERAPAMIL SR","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","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":""}]}]}