{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Antoine Elhayek","gend":0,"currentgend":"","add":"2 HARMONY LN","city":"NORTH EASTON","state":"MA","zip":"02356","dob":"1963-12-03","age":"","mstatus":"","insh":"C0006958300","cliId":"","pno":"5083333432","cno":"","email":"","ename":"","eno":"","pphy":"Nawar  Najjar","ppno":"5088800012","pcpadd":"675 Paramount Dr, Ste 203","pcpcity":"Raynham","pcpstate":"MA","pcpzip":"02767","pcpcounty":"","pcpid":"","pcpname":"Revere Medical of Massachusetts, P.C.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"2 HARMONY LN","madd2":"","madd3":"","mcity":"NORTH EASTON","mstate":"MA","mzip":"02356","pcpfaxno":"","pcpnpi":"1265445068","currentgendcomment":"","pphycomment":"","uniqueid":"66465100","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":["F419","J449","R058","R99","E785","F5101","M25511","M7989","R0609","F17210","Z122","E559","R7309","Z125","M7581","Z0001","G43909","Z1331","K219","Z1211","R030","G43009","I10","R42","H903","Z0000","R000","Z98890","J0190","H6993","N130","N401","N138","N529","R9720","H9313","I2510","I4711"],"date":["2026-03-01","2026-03-06","2026-04-02","2026-04-02","2026-05-17","2026-05-19","2026-02-11","2026-02-11","2026-02-12","2026-02-12","2026-02-12","2026-02-03","2026-02-03","2026-02-03","2026-02-11","2026-01-27","2026-01-27","2026-01-27","2026-01-27","2026-01-27","2025-10-09","2025-05-03","2025-06-03","2024-10-18","2024-09-04","2024-10-18","2024-10-18","2024-07-03","2024-03-28","2024-05-04","2024-12-03","2024-12-03","2024-12-03","2024-12-03","2024-12-03","2024-10-05","2024-09-05","2024-03-22"],"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":[["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","VENLAFAXINE HCL ER","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","VENLAFAXINE HCL","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","LOVASTATIN","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","BENZONATATE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","PREDNISONE","","","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":""}]}]}