{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ryan Benoit","gend":0,"currentgend":"","add":"174 LOWELL RD","city":"MASHPEE","state":"MA","zip":"02649","dob":"1979-08-20","age":"","mstatus":"","insh":"C0002386500","cliId":"","pno":5087760233,"cno":"","email":"","ename":"","eno":"","pphy":"Alexis W Tressor","ppno":5087904568,"pcpadd":"51 Main St,Ste 2","pcpcity":"Hyannis","pcpstate":"MA","pcpzip":"02601","pcpcounty":"","pcpid":"","pcpname":"Mamdouh Riad, MD, PC","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"UNIT 98","add3":"","madd1":"174 LOWELL RD","madd2":"UNIT 98","madd3":"","mcity":"MASHPEE","mstate":"MA","mzip":"02649","pcpfaxno":"","pcpnpi":1982227468,"currentgendcomment":"","pphycomment":"","uniqueid":58198100,"medicareid":"","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":["I10","G4700","R99","R891","E663","Z2981","F5101","L723","R350","J069","S71131A","Z7951","Z79899","J309","F900","F411","E669","Z6833","F988","Z7189","Z7182","Z0000","F1020","E782","R61","H109","W448XXA","Y9289","E039","E785","N400","Z1211","F909","E291","R682"],"date":["2025-08-13","2025-12-16","2025-12-21","2025-09-11","2024-11-10","2025-10-13","2025-11-11","2025-10-16","2025-12-31","2025-11-18","2024-08-28","2024-08-28","2024-08-28","2025-03-04","2025-08-13","2025-08-13","2025-03-04","2024-06-05","2024-08-05","2024-11-10","2024-11-10","2025-08-13","2025-03-04","2025-10-31","2024-08-14","2024-08-22","2024-08-28","2024-08-28","2025-03-04","2025-03-04","2025-10-31","2025-08-13","2025-10-30","2025-10-31","2025-11-11"],"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":[["","","LISINOPRIL","","","Select","Select",""],["","","ZOLPIDEM TARTRATE","","","Select","Select",""],["","","TOPIRAMATE","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","TESTOSTERONE CYPIONATE","","","Select","Select",""],["","","EMTRICITABINE-TENOFOVIR DISOP","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","AZITHROMYCIN","","","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":""}]}]}