{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael G Schotten","gend":0,"currentgend":"","add":"53 GILMAN HILL RD","city":"WOOLWICH","state":"ME","zip":"04579","dob":"1961-11-15","age":"","mstatus":"","insh":"10000064767","cliId":"","pno":2078412554,"cno":"","email":"mschotten@comcast.net","ename":"","eno":"","pphy":"STEELE, ERIK N","ppno":2077998596,"pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 142","madd2":"","madd3":"","mcity":"WOOLWICH","mstate":"ME","mzip":"04579","pcpfaxno":2078287850,"pcpnpi":1538176789,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1EC9A42EC11","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":["U071","R42","R945","L03116","I4720","J984","J9690","G4733","Z95810","E1142","L852","Z89429","L97522","I480","R079","I517","I700","I252","R531","J189","M25562","D72829","I10","E1165","I2510","I672","H25811","E785","E119","E1136","I214","R252","E875","J9621","K5732","I259","M25519","Z743","R0902","J949","R918","R0602","R200","R590","I358","Z23","Z4682","Z950","Z7901","R4182","R9089","Z48812","I255","E1169","I6523","A419","I5042","J9611","E8342","M546","K219","I5032","I739","J90","M1712","E118","R059","R0989","R5383","Z043","R0781","R0789","E11621","E876","E8351","I4819","N179","E1140","I130","E871","Z20822","R9431","I5189","I4510","Z794","I5033","R001","R778","D649","I4811","R110","G9340","I25709","E538","R000","R600","Z0100","Z136","I509","I77810","I471","J9601","I4892","I160","E1129","I499","R55","M25572","S0990XA","R413","N189","I4729","I21A1","I25810","M6281","R262","E6601","I2582","Z951","I4891","E1122","Z87891","R0600","I50810","R931","Z7409","K5730","I495","G9341","K5790","K7689","K8689","N281","R160","R7989","I420","R112","J188","T82858A","K3189","H25813","H25812","G2581","R911"],"date":["2024-03-06","2024-03-05","2023-02-06","2022-12-28","2024-02-12","2025-11-19","2025-11-11","2024-08-31","2025-10-08","2025-06-24","2025-06-02","2025-06-02","2025-06-24","2025-09-17","2025-07-06","2025-05-17","2024-10-23","2024-02-12","2024-02-17","2023-08-17","2023-08-11","2023-08-11","2025-10-08","2025-07-08","2025-05-15","2024-03-05","2022-12-14","2022-12-14","2022-12-14","2022-12-14","2025-07-06","2023-08-17","2024-05-11","2025-05-16","2024-02-17","2023-08-03","2024-07-08","2024-07-08","2024-07-08","2025-05-15","2025-07-05","2025-05-16","2025-05-15","2025-05-15","2025-05-17","2025-10-06","2024-02-17","2024-05-01","2024-02-27","2024-02-17","2024-07-08","2023-07-28","2025-09-08","2023-07-31","2024-02-17","2024-02-17","2023-08-10","2024-02-25","2024-02-25","2024-07-08","2022-12-05","2025-07-06","2024-08-14","2023-08-10","2023-08-10","2025-10-06","2024-03-05","2025-07-05","2024-03-05","2024-07-08","2024-07-08","2024-10-23","2023-11-15","2023-07-20","2023-07-20","2025-03-25","2024-01-11","2023-07-27","2024-05-02","2022-12-25","2024-01-11","2024-10-24","2024-10-24","2024-10-24","2023-07-27","2024-05-02","2023-07-14","2023-07-24","2024-01-08","2023-07-20","2022-12-05","2024-01-11","2024-10-25","2025-03-24","2023-07-26","2023-01-25","2023-02-20","2025-07-05","2025-07-05","2025-07-05","2023-07-22","2024-05-03","2024-05-02","2025-07-05","2023-02-06","2023-07-20","2023-07-20","2023-07-21","2023-07-20","2022-11-28","2024-05-01","2023-07-27","2023-07-27","2023-07-27","2024-02-17","2024-01-11","2024-01-11","2023-07-24","2023-07-26","2022-12-28","2022-12-28","2023-07-10","2023-07-10","2023-07-11","2023-07-11","2023-11-03","2023-07-26","2023-07-26","2024-01-12","2022-11-16","2022-11-16","2022-11-16","2022-11-16","2022-11-15","2022-11-15","2022-11-15","2022-11-21","2022-11-15","2022-11-15","2022-11-21","2022-10-12","2022-10-12","2022-09-22","2022-09-22"],"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":[["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","WARFARIN SODIUM","","","Select","Select",""],["","","FREESTYLE LIBRE 3 PLUS SENSOR","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","SAFETYGLIDE INSULIN SYRINGE","","","Select","Select",""],["","","FREESTYLE LIBRE 2 SENSOR","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","BASAGLAR KWIKPEN U-100","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","FENOFIBRATE","","","Select","Select",""],["","","SEMGLEE (YFGN) PEN","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","BUPROPION HCL SR","","","Select","Select",""],["","","AMIODARONE HCL","","","Select","Select",""],["","","CEFDINIR","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","FREESTYLE LIBRE 2 READER","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","CONTOUR NEXT TEST STRIP","","","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":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}