{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Elnora F Scofield","gend":1,"currentgend":"","add":"872 MAIN STREET","city":"MILFORD","state":"ME","zip":"04461","dob":"1948-09-22","age":"","mstatus":"","insh":"10000026599","cliId":"","pno":2078272869,"cno":"","email":"hunkswife@hotmail.com","ename":"","eno":"","pphy":"DRUAN, KRISTEN","ppno":2079073300,"pcpadd":"C\/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT,PO BOX 7291","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42437291","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"P O BOX 353","madd2":"","madd3":"","mcity":"MILFORD","mstate":"ME","mzip":"04461","pcpfaxno":2079071923,"pcpnpi":1770911430,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2NT0KJ5PH09","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25511","S46001D","Z0100","I10","Z538","Q438","B3731","Z539","M75121","Z0000","E1165","K219","K5900","M25521","M7521","W1809XA","Y92008","E119","E538","K529","Z1231","M19011","J208","R062","M21079","M2042","M2041","E1142","M67813","M7551","R0609","N393","F419","F3289","R1012","S46911A","R1033","M67911","S46011D","K625","M65862","M5450","G8929","Z96652","R6889","R0789","W010XXD","I493","I491","M2142","M2141","E039"],"date":["2025-10-08","2023-08-09","2025-10-01","2025-09-30","2024-05-31","2024-05-31","2025-08-11","2024-05-31","2025-07-29","2025-05-30","2025-09-30","2023-05-24","2024-04-09","2025-04-16","2025-04-16","2023-05-13","2023-05-13","2025-10-08","2024-08-28","2024-04-09","2025-08-18","2023-07-25","2025-01-10","2025-01-10","2025-04-28","2025-04-28","2025-04-28","2024-06-17","2024-09-04","2024-09-04","2025-07-08","2025-07-08","2024-08-15","2024-09-30","2023-09-07","2023-05-13","2025-05-15","2023-07-25","2023-10-02","2023-09-07","2023-07-06","2023-07-06","2023-07-06","2023-07-06","2023-11-01","2025-05-07","2023-09-05","2025-05-07","2025-05-07","2022-10-03","2022-10-03","2022-08-30"],"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":[["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","ATENOLOL","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","ARIPIPRAZOLE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","CLOTRIMAZOLE-BETAMETHASONE","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","FREESTYLE LIBRE 2 SENSOR","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","FREESTYLE LIBRE 2 READER","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","LACTULOSE","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","METHOCARBAMOL","","","Select","Select",""],["","","FOSFOMYCIN TROMETHAMINE","","","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":{"indx":[],"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":""}]}]}