{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sharon L Russell","gend":1,"currentgend":"","add":"183 ALLEN HILL RD","city":"OXFORD","state":"ME","zip":"04270","dob":"1946-03-06","age":"","mstatus":"","insh":"10000090249","cliId":"","pno":2078904307,"cno":"","email":"sharonrussell51866@gmail.com","ename":"","eno":"","pphy":"ENRIGHT, NICHOLAS","ppno":2077847388,"pcpadd":"Family Health Care Associates,190 Stetson Rd","pcpcity":"Auburn","pcpstate":"ME","pcpzip":"04210","pcpcounty":"","pcpid":"","pcpname":"FAMILY HEALTH CARE ASSOCIATES","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"183 ALLEN HILL RD","madd2":"","madd3":"","mcity":"OXFORD","mstate":"ME","mzip":"04270","pcpfaxno":2077952043,"pcpnpi":1801457858,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6Y29D41HJ18","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E785","Z0000","R6889","K635","Z86010","F419","F32A","M8580","J00","H02834","J45909","Z20822","H02831","Z0100","J45901","M1711","Z0101","H18513","N390","R059","K5900","J449","Z23","E669","K5909","N3941","D225","L918","L821","D229","L989","L84","N819","F418","M25561","R300","N816"],"date":["2025-03-06","2024-09-12","2023-12-12","2023-10-18","2023-10-18","2023-04-21","2023-04-21","2023-04-21","2022-11-30","2024-03-15","2025-01-07","2022-11-30","2024-03-15","2022-12-06","2024-04-26","2023-08-24","2024-12-17","2024-12-17","2025-01-07","2023-08-11","2024-09-10","2023-09-19","2023-10-13","2025-09-22","2024-07-10","2022-11-10","2022-10-28","2022-10-28","2022-10-07","2022-10-07","2022-10-14","2022-10-14","2022-10-14","2022-09-16","2022-09-16","2022-09-20","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":[["","","AMOXICILLIN","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","FLUTICASONE PROPIONATE HFA","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","FLOVENT HFA","","","Select","Select",""],["","","ADVAIR DISKUS","","","Select","Select",""],["","","PEG-3350 AND ELECTROLYTES","","","Select","Select",""],["","","CLONIDINE HCL","","","Select","Select",""],["","","MYRBETRIQ","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","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":""}]}]}