{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda M Swierk","gend":1,"currentgend":"","add":"238 BAIZLEY RD","city":"Turner","state":"ME","zip":"04282","dob":"1949-06-22","age":"","mstatus":"","insh":"10000033933","cliId":"","pno":2072252634,"cno":2073330579,"email":"Lindamay49@hotmail.com","ename":"","eno":"","pphy":"RIVARD, GARY S","ppno":2075243501,"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":"PO BOX 533","madd2":"","madd3":"","mcity":"Turner","mstate":"ME","mzip":"04282","pcpfaxno":2076476015,"pcpnpi":1194801993,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9MG1JD8JA94","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N1831","N259","R208","M19041","G4733","R300","Z1231","K219","K5732","E785","E063","I700","J9601","R112","R109","I2510","A419","E874","D696","J90","K5792","K8020","N281","K449","R1310","Z01818","M889","L03116","M47814","M5383","I10","M65331","M65341","Z98890","R0683","I872","N952","Z0000","R918","E559","H43813","H532","G43719","Z23","M47894","R519","Z0389","H26493","M25559","T1490XA","H903","E039","M5459","Z5181","K5730","J0190","R6889","R748","M7910","M47819","M88851","R0602","M5450","M79641","M180","R7301","M810","M549","R296","Z01810","R079","E875","I429","R400","E669","K224","R0789","R0609","R7989","I119","N3289","K529","K5790","A084","S2220XA","S2242XA","K2080","Z780","M8589","R413","I252","M4316","M47816","R52"],"date":["2025-04-14","2025-04-14","2025-04-14","2025-01-07","2025-09-10","2023-07-24","2024-10-17","2024-04-01","2023-07-26","2025-03-31","2025-09-02","2023-07-26","2023-07-31","2023-07-31","2023-07-31","2025-06-23","2023-07-26","2023-07-26","2023-07-26","2023-07-26","2024-10-11","2023-07-30","2023-07-30","2024-04-01","2024-04-01","2024-04-01","2025-01-17","2023-03-08","2023-03-22","2023-03-08","2025-10-29","2025-08-12","2025-04-07","2024-04-17","2025-06-23","2023-07-30","2023-03-28","2024-10-01","2023-07-26","2025-02-26","2025-02-20","2025-02-20","2023-10-10","2025-11-12","2023-03-22","2023-06-22","2025-01-17","2023-03-30","2024-03-26","2024-03-26","2024-05-24","2025-06-10","2025-07-09","2025-07-09","2024-01-08","2024-01-16","2023-06-05","2023-05-19","2023-05-19","2023-05-05","2025-01-17","2023-06-22","2023-04-11","2025-01-07","2025-07-30","2025-11-11","2024-08-06","2024-05-07","2024-05-07","2024-02-19","2023-02-08","2022-12-19","2023-01-09","2024-05-30","2024-07-17","2024-05-21","2022-12-30","2022-12-30","2022-12-30","2022-12-30","2025-06-24","2025-06-24","2025-06-24","2025-06-24","2022-12-30","2022-12-30","2023-02-28","2022-10-25","2022-10-25","2022-10-03","2022-09-20","2022-08-10","2022-08-10","2022-08-10"],"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":[["","","BUSPIRONE HCL","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","PEG-3350 AND ELECTROLYTES","","","Select","Select",""],["","","GAVILYTE-G","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","METOCLOPRAMIDE HCL","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","METRONIDAZOLE","","","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":""}]}]}