{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Robert P Sweet","gend":0,"currentgend":"","add":"8 MAIN ST","city":"SOUTH FREEPORT","state":"ME","zip":"04078","dob":"1957-01-10","age":"","mstatus":"","insh":"10000091861","cliId":"","pno":2078654971,"cno":"","email":"rsweetski@gmail.com","ename":"","eno":"","pphy":"PIERCE, DANIEL C","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":"PO BOX 213","madd2":"","madd3":"","mcity":"S FREEPORT","mstate":"ME","mzip":"04078","pcpfaxno":2078741483,"pcpnpi":1861451080,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4RE0Q87AC23","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z125","I10","F331","Z1211","D123","K5730","K648","R21","R002","F439","F419","F5101","H01009","M25551","M25651","M24559","M2560","Z0000","Z23","J4530","Z0101","R6889","H00014","J3089","L719","R0789","K5790","R3915","G4700","K635","D225","D2371","D2372","L738","M5441","M6281","M5416","K5900","M25559","H35722","D3131","H2513","H5213","D492","D485"],"date":["2024-12-26","2024-12-26","2025-11-13","2023-12-27","2023-12-27","2023-12-27","2023-12-27","2024-06-11","2024-05-13","2025-09-09","2025-04-10","2025-04-10","2025-10-01","2023-05-03","2023-05-03","2023-05-03","2023-05-03","2025-09-09","2025-09-15","2025-09-23","2025-08-05","2023-04-01","2023-10-17","2023-10-17","2025-04-10","2025-07-14","2024-02-26","2025-09-09","2025-09-09","2023-12-27","2023-08-25","2023-08-25","2023-08-25","2023-08-25","2022-10-06","2022-10-06","2022-08-16","2022-08-16","2022-08-05","2022-04-28","2022-04-28","2022-04-28","2022-04-28","2022-04-04","2022-04-04"],"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":[["","","SERTRALINE HCL","","","Select","Select",""],["","","BREO ELLIPTA","","","Select","Select",""],["","","ZOLPIDEM TARTRATE","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","XDEMVY","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","BETAMETHASONE VALERATE","","","Select","Select",""],["","","CLONAZEPAM","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","DICYCLOMINE HCL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","PFIZER COVID (12Y UP) VAC(EUA)","","","Select","Select",""],["","","TOBRADEX","","","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":""}]}]}