{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Stephen M Sweeney","gend":0,"currentgend":"","add":"183 WARWICK ST","city":"PORTLAND","state":"ME","zip":"04102","dob":"1955-04-18","age":"","mstatus":"","insh":"10000076643","cliId":"","pno":2077499654,"cno":"","email":"ssweeney@maine.rr.com","ename":"","eno":"","pphy":"PHAN, ANDREW T","ppno":2078282402,"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":"183 WARWICK ST","madd2":"","madd3":"","mcity":"PORTLAND","mstate":"ME","mzip":"04102","pcpfaxno":2078287850,"pcpnpi":1619918307,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1UV2YY7QR18","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E1165","Z96642","T84021A","E785","Z125","M25552","G4733","I10","M5450","M47816","L089","G600","M9702XD","R262","Z471","M1611","S72002A","S72112A","M79662","M259","S73005A","R609","N400","M25551","M19071","T8482XA","S72302A","R4182","E6601","T84011A","E119","E11621","M79671","R0602","R059","I700","I517","R6883","L97412","Z7984","R600","L97512","M21179","E1142","L97519","Z0101","R509","G629","M14671","J811","R918","R7989","D72829","F17210","L03115","D729","E538","A419","L989","T84011D","L97509","Z4789","B351","L97511","E11622","L98499","T8189XA","S91301A","M7989","L89513","S91001A","L89512","J189","R42","Z1152","R0989","F5104","G2581","E668","Z23"],"date":["2025-08-14","2025-01-16","2024-02-15","2025-02-10","2024-03-16","2024-02-20","2025-08-13","2025-01-30","2024-02-11","2024-02-11","2025-02-10","2025-02-25","2024-03-05","2024-02-23","2024-04-03","2024-02-17","2024-02-20","2024-02-21","2024-02-21","2024-02-16","2024-02-15","2024-02-15","2024-02-15","2024-02-17","2025-02-10","2024-02-17","2024-02-21","2024-02-21","2024-02-21","2024-02-17","2025-02-10","2025-03-12","2025-01-15","2025-01-22","2025-01-16","2025-01-22","2025-01-16","2025-01-16","2025-02-06","2025-02-06","2024-12-13","2025-01-15","2025-01-15","2025-02-06","2025-02-06","2025-10-16","2025-01-20","2025-01-20","2025-01-20","2025-01-22","2025-01-16","2025-01-16","2025-01-16","2025-01-16","2025-02-28","2025-01-30","2025-01-30","2025-01-20","2025-11-06","2024-02-24","2025-02-10","2024-04-03","2025-02-10","2024-07-12","2025-03-07","2025-03-07","2025-03-07","2024-05-11","2024-05-11","2023-09-14","2023-07-28","2023-08-02","2023-10-29","2023-10-29","2023-10-29","2023-08-31","2022-07-26","2022-07-26","2022-07-26","2022-04-14"],"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":[["","","METFORMIN HCL","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","POLYMYXIN B SUL-TRIMETHOPRIM","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","CEFADROXIL","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","VICTOZA 3-PAK","","","Select","Select",""],["","","UNIFINE PENTIPS PLUS","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","PULMICORT FLEXHALER","","","Select","Select",""],["","","CLICKFINE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","VICTOZA 2-PAK","","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","JARDIANCE","","","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":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}