{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Pamela C Schoening","gend":1,"currentgend":"","add":"11 BURLIEGH ST","city":"WATERVILLE","state":"ME","zip":"04901","dob":"1955-02-18","age":"","mstatus":"","insh":"10000074904","cliId":"","pno":2076808896,"cno":"","email":"declined@04282025.com","ename":"","eno":"","pphy":"PRESTON, DAVID G","ppno":2078731098,"pcpadd":"Mid Maine Medicine,325B Kennedy Memorial Dr","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"THAYER INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"11 BURLIEGH ST","madd2":"","madd3":"","mcity":"WATERVILLE","mstate":"ME","mzip":"04901","pcpfaxno":2078735461,"pcpnpi":1871559203,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7DG3FD8EU09","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H20043","H25093","D72819","D696","H209","D61818","R5383","Z87891","R0601","S92354D","J45909","Z79631","Z13220","Z8669","I4891","H30113","H40043","H35373","H44113","F341","F411","F4310","M79671","R079","X58XXXD","R609","R030","Z79899","H3093","F419","F418","R748","I2720","I081","R7989","S0993XA","G5602","S0990XA","M19071","Z780","Z1231","H1132","R600","J205","R059","R0602","I10","H02059","J069","B9789","M7989","R002","H5213","H524","H52223","J0190","R6889","B9689","Z20828","G4700","K828","K760","K7401","I4819","M25561","S01511A","W010XXA","H44119","R635","F4312","F410","Z7952","E559","K7689","I4820","R2681","W208XXD","Z7689","Z0000","R718","S92901A","I4811","J329","S92354A","W208XXA","Z79620","R0600","Z801","S92301D","Z23","K5900","R0982","F909","M79641"],"date":["2025-10-22","2025-10-22","2024-12-17","2024-04-22","2024-07-11","2025-02-28","2024-03-15","2025-08-07","2025-09-08","2023-10-23","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2025-10-06","2023-10-19","2025-10-02","2023-08-18","2025-10-02","2023-12-07","2024-09-03","2024-07-15","2023-08-28","2025-09-28","2023-08-28","2023-08-28","2023-11-28","2025-10-02","2025-10-02","2025-08-07","2024-07-15","2024-08-08","2024-05-02","2024-05-02","2025-09-11","2023-09-23","2025-07-01","2023-09-23","2023-08-28","2023-11-30","2025-05-28","2025-10-22","2024-06-03","2024-01-09","2024-02-09","2024-01-09","2025-09-07","2025-01-23","2025-02-10","2025-02-10","2024-06-03","2024-06-03","2024-08-09","2024-08-09","2024-08-09","2024-01-06","2022-12-29","2024-01-06","2024-01-06","2024-09-03","2024-08-08","2025-02-05","2024-08-08","2025-09-26","2024-04-16","2023-09-23","2023-09-23","2025-08-20","2024-04-16","2022-12-09","2022-12-09","2024-06-28","2025-04-10","2024-05-16","2025-09-28","2023-10-23","2023-10-23","2025-04-08","2025-08-07","2023-01-16","2023-08-28","2025-10-13","2025-04-10","2023-07-31","2023-07-31","2024-09-12","2025-09-07","2025-04-08","2023-06-30","2023-01-13","2025-02-05","2022-11-01","2022-10-11","2022-09-07"],"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":[["","","ALBUTEROL SULFATE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","BRINZOLAMIDE","","","Select","Select",""],["","","SIMBRINZA","","","Select","Select",""],["","","HUMIRA(CF) PEN","","","Select","Select",""],["","","LUMIGAN","","","Select","Select",""],["","","DILTIAZEM 24HR ER (CD)","","","Select","Select",""],["","","BRIMONIDINE TARTRATE","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","METHOTREXATE","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","CLONAZEPAM","","","Select","Select",""],["","","CLOTRIMAZOLE","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","EYSUVIS","","","Select","Select",""],["","","ALPHAGAN P","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","MNEXSPIKE 2025-2026 (12Y UP)","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","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":{"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":[]}},{"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":""}]}]}