{"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 - Wave 2","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":["D122","D128","Z7901","Z1211","Z86010","B351","M79675","M79674","E1142","E1122","Z0000","I10","I480","I2510","I4821","L814","L821","Z08","Z85828","L570","S0990XA","R9082","R262","R809","I4892","Z951","S0081XA","W06XXXA","Z7189","I4891","R627","X32XXXA","R269","I130","Z48812","D649","S79911A","R001","I5020","Z23","I4811","R531","R5381","N390","R2689","Z9189","Z5181","R1013","R4182","J189","Z043","M546","R109","I455","R55","F0390","F0150","R339","R410","R300"],"date":["2023-04-11","2023-04-11","2026-02-16","2023-04-11","2023-04-11","2025-08-18","2025-08-18","2025-08-18","2025-08-18","2026-01-26","2024-06-13","2025-10-13","2025-11-01","2026-01-01","2026-01-19","2024-10-10","2024-10-10","2024-10-10","2024-10-10","2024-10-10","2023-10-14","2023-10-14","2025-01-20","2024-01-05","2025-05-23","2024-02-08","2023-10-14","2023-10-14","2024-06-13","2025-12-31","2025-12-03","2024-10-10","2025-09-16","2025-09-17","2025-11-01","2025-09-25","2025-09-14","2025-12-29","2025-10-28","2025-10-15","2026-03-02","2025-11-26","2025-12-03","2025-11-20","2026-01-26","2026-01-26","2026-02-18","2026-02-17","2025-12-03","2025-12-03","2025-09-14","2025-09-14","2025-09-14","2025-09-15","2025-09-14","2026-01-19","2026-02-05","2025-10-28","2025-10-27","2025-10-27"],"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":[["","","WARFARIN","5 MG","","Select","Select",""],["","","JANTOVEN","","","Select","Select",""],["","","METFORMIN","500 MG","","Select","Select",""],["","","Dorzolamide\/Timolol 2\/0.5 % Ophth Sol Auro","","","Select","Select",""],["","","Sacubitril\/Valsartan","24\/26 MG","","Select","Select",""],["","","TAMSULOSIN","0.4 MG","","Select","Select",""],["","","FLUZONE HIGH-DOSE","","","Select","Select",""],["","","SACUBITRIL-VALSARTAN","","","Select","Select",""],["","","Atorvastatin","40 MG","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","CARVEDILOL","6.25 MG","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","GABAPENTIN","100 MG","","Select","Select",""],["","","ROSUVASTATIN","20 MG","","Select","Select",""],["","","Latanoprost 0.005 % Ophth Sol Somerset","","","Select","Select",""],["","","Iyuzeh","","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","OLMESARTAN","40 MG","","Select","Select",""],["","","Dorzolamide\/Timolol 2\/0.5 % Ophth Sol B&L","","","Select","Select",""],["","","Latanoprost 0.005 % Ophth Sol Sandoz","","","Select","Select",""],["","","GAVILYTE-G","","","Select","Select",""],["","","DORZOLAMIDE\/TIMOLOL","2\/0.5 %","","Select","Select",""],["","","LATANOPROST","0.00005","","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":""}]}]}