{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"George A Sweetland","gend":0,"currentgend":"","add":"59 ROGERS RD","city":"YARMOUTH","state":"ME","zip":"04096","dob":"1942-07-20","age":"","mstatus":"","insh":"10000055176","cliId":"","pno":2078464927,"cno":"","email":"gsweetland1@gmail.com","ename":"","eno":"","pphy":"PATCH, JEFFREY S","ppno":2078469013,"pcpadd":"InterMed,259 Main St","pcpcity":"Yarmouth","pcpstate":"ME","pcpzip":"04096","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"59 ROGERS RD","madd2":"","madd3":"","mcity":"YARMOUTH","mstate":"ME","mzip":"04096","pcpfaxno":2078741483,"pcpnpi":1720067317,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9XJ4X23QV82","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R5382","R0602","M40204","I517","K449","Z23","H903","J189","R509","E1165","E1169","E1136","Z794","J479","N179","A419","S0990XA","Z713","R053","G9341","Z66","J690","R197","Z0000","E7800","I10","C44612","H18451","D492","L814","D225","L821","D1801","L570","M5450","K219","E1159","H43823","H40051","E119","I5189","I499","Z961","Z79891","R109","R4182","R32","R059","R531","Z20822","Z85828","G4719","R0683","U071","J101","Z1159"],"date":["2024-11-04","2023-11-28","2023-11-28","2023-11-28","2023-11-28","2025-09-03","2023-11-07","2023-12-01","2023-11-28","2025-07-17","2025-02-28","2024-06-10","2025-02-25","2024-06-13","2024-06-13","2024-06-14","2024-06-13","2025-04-01","2024-08-29","2024-06-14","2024-06-14","2024-06-14","2023-12-01","2025-09-03","2025-07-17","2024-08-22","2025-07-30","2024-02-22","2025-06-11","2025-06-11","2025-06-11","2025-06-11","2025-06-11","2025-06-11","2025-02-28","2025-02-28","2025-02-28","2025-02-25","2023-01-18","2025-02-25","2024-06-14","2024-06-14","2025-02-25","2023-02-22","2024-06-13","2024-06-13","2024-06-13","2023-11-28","2023-11-28","2023-11-28","2022-08-23","2022-07-21","2022-07-21","2022-06-27","2022-05-03","2022-05-07"],"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":[["","","DEXCOM G7 RECEIVER","","","Select","Select",""],["","","DEXCOM G7 SENSOR","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ULTRA-FINE PEN NEEDLE","","","Select","Select",""],["","","ENALAPRIL MALEATE","","","Select","Select",""],["","","ULTRA-FINE MINI PEN NEEDLE","","","Select","Select",""],["","","NOVOLOG MIX 70-30 FLEXPEN","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","BACLOFEN","","","Select","Select",""],["","","FREESTYLE LIBRE 14 DAY SENSOR","","","Select","Select",""],["","","IPRATROPIUM BROMIDE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","IRBESARTAN","","","Select","Select",""],["","","INSULIN ASPART PROT MIX 70-30","","","Select","Select",""],["","","UNIFINE PENTIPS PLUS","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","ONETOUCH VERIO TEST STRIP","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","ONETOUCH VERIO FLEX METER","","","Select","Select",""],["","","ONETOUCH VERIO METER","","","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":""}]}]}