{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Annmarie Frazer","gend":1,"currentgend":"","add":"44 WESTGATE RD","city":"CHESTNUT HILL","state":"MA","zip":"02467","dob":"1985-11-28","age":"","mstatus":"","insh":"C0006446700","cliId":"","pno":"8572431318","cno":"","email":"","ename":"","eno":"","pphy":"Jennifer J VanderWeele","ppno":"6178259660","pcpadd":"637 Washington St","pcpcity":"Dorchester","pcpstate":"MA","pcpzip":"02124","pcpcounty":"","pcpid":"","pcpname":"Codman Square Health Center","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"APT 2","add3":"","madd1":"44 WESTGATE RD","madd2":"APT 2","madd3":"","mcity":"CHESTNUT HILL","mstate":"MA","mzip":"02467","pcpfaxno":"","pcpnpi":"1841682127","currentgendcomment":"","pphycomment":"","uniqueid":"66181050","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":["O98811","O99891","M130","O26611","O99011","O99281","O99111","D509","D75839","E282","A5442","E7800","K760","O3481","M009","M65941","R7303","O09521","Z3A01","Z79811","Z8249","Z8261","Z833","Z885","Z114","Z3481","J029","O209","Z3A09","O039","Z113","R509","M25511","G8929","M25512","Z7251","Z8709","M2550","M25462","M25562","M6590","J0390","M1380","R7982","M1990","M25531","M25431","M65931","M7989","M79605","M79641","R7881","R9431","M00062","R1310","M542","R0789","R109","I159","Z4802","Z95828","I10","N979","R99","R52","Z124","Z30432","R87610","R87810","Z3169","E119","H5203","H35411","O24410","H52203"],"date":["2025-08-16","2025-08-16","2025-08-16","2025-08-16","2025-08-16","2025-08-16","2025-08-16","2025-08-16","2025-08-16","2025-08-27","2025-08-16","2025-08-16","2025-08-16","2025-08-16","2025-10-10","2025-08-16","2025-08-16","2025-08-16","2025-08-16","2025-08-18","2025-08-16","2025-08-16","2025-08-16","2025-08-16","2025-08-27","2025-09-11","2025-09-22","2025-10-02","2025-10-02","2025-10-13","2025-10-13","2025-08-04","2025-08-12","2025-08-12","2025-08-12","2025-08-12","2025-08-18","2025-08-14","2025-08-26","2025-08-14","2025-08-20","2025-08-20","2025-08-20","2025-08-20","2025-08-20","2025-08-25","2025-08-25","2025-08-22","2025-10-23","2025-08-16","2025-08-19","2025-08-21","2025-08-21","2025-08-26","2025-09-22","2025-09-22","2025-09-22","2025-09-22","2025-10-10","2025-08-28","2025-08-28","2025-10-23","2025-12-18","2026-04-20","2025-08-14","2025-04-07","2025-04-07","2025-04-07","2025-04-07","2025-04-07","2025-04-28","2025-04-28","2025-04-28","2025-04-28","2025-04-28"],"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":[["","","PRENATAL VITAMIN","","","Select","Select",""],["","","LETROZOLE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","METOCLOPRAMIDE HCL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ENOXAPARIN SODIUM","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","FLUNISOLIDE","","","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":""}]}]}