{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sharon L Blevins","gend":1,"currentgend":"","add":"99 MAIN ST","city":"TURNER","state":"ME","zip":"04282","dob":"1948-08-24","age":"","mstatus":"","insh":"10000012926","cliId":"","pno":2075006731,"cno":"","email":"justsher03@aol.com","ename":"","eno":"","pphy":"BRADBURY, LESLIE","ppno":2073690146,"pcpadd":"180 CHURCH HILL RD STE 1,","pcpcity":"LEEDS","pcpstate":"ME","pcpzip":"42633418","pcpcounty":"","pcpid":"","pcpname":"DFD RUSSELL MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"99 MAIN ST","madd2":"","madd3":"","mcity":"TURNER","mstate":"ME","mzip":"04282","pcpfaxno":2073648626,"pcpnpi":1952749723,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4F64YE1JC06","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M958","K4090","R0781","I10","T2640XA","Z01810","I4891","Z01818","M25512","D123","S63004A","M19031","M25531","M7989","S37039D","J9811","S0501XD","S37091A","S2241XA","I517","S63501A","R0602","S37061A","S0501XA","I480","N289","S61239A","W460XXA","Z7901","R2231","S37031A","R1030","M5459","R42","Z86010","K5730","M1711","M7062","R079","I2510","N280","R0609","L309","M25561","C44319","L578","L814","L821","Z85828","R0789","R0782","H6992","R222","S37039A","F1090","Q791","W01198A","W19XXXA","D62","J9601","R059","Z789","S79921A","S8991XA","Z0000","D492","F1099","H353132","Z961","Z135","S37009A","Z1231"],"date":["2025-05-14","2024-08-27","2023-06-19","2025-08-07","2025-08-07","2025-04-15","2025-04-15","2025-02-11","2025-07-23","2023-10-24","2023-08-01","2024-06-29","2023-08-01","2023-08-01","2023-05-27","2023-05-22","2025-08-25","2023-05-19","2023-05-27","2023-06-19","2024-06-29","2023-05-30","2023-05-25","2025-08-07","2024-04-03","2023-09-22","2025-05-14","2025-05-14","2023-06-19","2024-06-29","2023-05-19","2023-05-18","2023-05-18","2023-05-18","2023-10-24","2023-10-24","2023-03-07","2024-01-02","2023-06-19","2023-06-19","2023-08-10","2025-04-02","2023-07-18","2023-03-03","2024-02-27","2024-04-24","2024-04-24","2024-04-24","2024-04-24","2023-06-19","2023-06-19","2025-06-16","2025-05-29","2023-05-27","2023-05-25","2023-05-24","2023-05-19","2023-05-26","2023-05-27","2023-05-23","2025-03-18","2023-05-20","2023-03-03","2023-03-03","2023-06-21","2023-10-04","2023-07-26","2024-05-24","2024-05-24","2024-05-24","2023-05-21","2022-11-11"],"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":[["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","CEFDINIR","","","Select","Select",""],["","","TOBRAMYCIN-DEXAMETHASONE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","ATENOLOL-CHLORTHALIDONE","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","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":""}]}]}