{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Gerald B Schofield","gend":0,"currentgend":"","add":"81 HUNTER RD","city":"FREEPORT","state":"ME","zip":"04032","dob":"1952-07-07","age":"","mstatus":"","insh":"10000062140","cliId":"","pno":2076710573,"cno":"","email":"Terry.schofield2@gmail.com","ename":"","eno":"","pphy":"SOMMER, JOHN E","ppno":2077984400,"pcpadd":"Martins Point Health Care,114 Bath Rd","pcpcity":"Brunswick","pcpstate":"ME","pcpzip":"04011","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"81 HUNTER RD","madd2":"","madd3":"","mcity":"FREEPORT","mstate":"ME","mzip":"04032","pcpfaxno":2078287850,"pcpnpi":1275732364,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8CU4HG9ET98","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C649","K7689","K760","I2510","I4892","N400","E119","L570","C641","R9720","Z0001","I10","N401","R609","Z125","I454","R002","I25119","N2889","L820","L821","Z0101","Z85528","I517","Z0000","E782","L578","Z1211","Z86010","Z800","Z87891","R6889","R160","R932","N281","K4020","R000","E785","R197","N179","E876","I358","R350","N3001","D3501","R4182","H1031","Z4889","L209","E6601","L918"],"date":["2024-08-30","2024-08-30","2025-10-29","2024-08-30","2025-05-12","2025-10-29","2025-11-17","2025-08-26","2025-10-29","2025-03-07","2023-09-29","2025-11-17","2023-09-29","2023-09-29","2024-03-19","2024-12-12","2025-05-12","2025-05-12","2023-03-30","2025-08-26","2025-08-26","2025-06-06","2025-10-29","2025-05-01","2025-11-17","2025-11-17","2025-02-24","2024-06-04","2024-06-04","2024-06-04","2024-06-04","2023-11-03","2025-03-14","2025-03-14","2025-03-14","2025-10-29","2024-12-11","2024-06-04","2024-10-22","2024-10-22","2024-10-22","2025-05-01","2023-11-11","2023-11-11","2022-12-05","2023-02-09","2023-07-25","2023-03-09","2023-07-12","2022-09-26","2022-09-26"],"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":[["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","CHLORTHALIDONE","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","LOVASTATIN","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","CEFPODOXIME PROXETIL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","ADVAIR HFA","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","TOBRAMYCIN-DEXAMETHASONE","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","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":{"indx":[["","","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}