{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jing Hong Su","gend":0,"currentgend":"","add":"92 APPALOOSA WAY","city":"TAUNTON","state":"MA","zip":"02780","dob":"1966-05-05","age":"","mstatus":"","insh":"C0006337900","cliId":"","pno":"8576540288","cno":"","email":"","ename":"","eno":"","pphy":"Carolyn E Phelan","ppno":"6174146800","pcpadd":"930 Commonwealth Ave","pcpcity":"Boston","pcpstate":"MA","pcpzip":"02215","pcpcounty":"","pcpid":"","pcpname":"Boston University Family Medicine,Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"92 APPALOOSA WAY","madd2":"","madd3":"","mcity":"TAUNTON","mstate":"MA","mzip":"02780","pcpfaxno":"","pcpnpi":"1235848029","currentgendcomment":"","pphycomment":"","uniqueid":"66119350","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["Chinese"]],"comment":[[]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E119","I10","R99","E785","Z7984","M25561","M25562","G8929","R079","F17210","M549","M1712","M1711","R0602","R0789","H52223","F17200","E1169","Z125","Z122","R059","Z79899","Z0000","Z5919","Z5941","Z5987","Z719","Z23","E1136","H2513","N529","Z713"],"date":["2026-04-16","2026-04-16","2026-04-14","2026-04-14","2025-12-12","2026-01-16","2026-01-16","2026-01-16","2026-04-14","2026-04-14","2025-12-16","2026-01-16","2026-01-16","2026-04-14","2026-04-14","2026-05-12","2025-04-18","2025-04-18","2024-07-31","2024-08-19","2024-07-31","2024-07-31","2024-10-28","2024-10-28","2024-10-28","2024-10-28","2024-10-28","2024-10-28","2024-11-29","2024-11-29","2025-04-18","2025-04-18"],"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",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","FREESTYLE LANCETS","","","Select","Select",""],["","","NICOTINE PATCH","","","Select","Select",""],["","","FREESTYLE LITE TEST STRIP","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","NICOTINE LOZENGE","","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","IBUPROFEN","","","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":""}]}]}