{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Scott Brown","gend":0,"currentgend":"","add":"75 KERRY DR","city":"MARSTONS MLS","state":"MA","zip":"02648","dob":"1982-03-19","age":"","mstatus":"","insh":"C0007040800","cliId":"","pno":"5087289859","cno":"","email":"","ename":"","eno":"","pphy":"Zouhdi A Hajjaj","ppno":"5087602054","pcpadd":"21 Aarons Way, Unite 2","pcpcity":"W Yarmouth","pcpstate":"MA","pcpzip":"02673","pcpcounty":"","pcpid":"","pcpname":"Yarmouth Medical Center, LLC","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"75 KERRY DR","madd2":"","madd3":"","mcity":"MARSTONS MLS","mstate":"MA","mzip":"02648","pcpfaxno":"","pcpnpi":"1942262795","currentgendcomment":"","pphycomment":"","uniqueid":"66520800","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":["J45909","G629","G4700","J3089","M9903","M9904","M9902","M5441","M533","M62830","Z0000","E663","F321","M961","G8929","L700","N522","N200","R030","E7800","Z1339","J3489","J342","J343","G4733","R99","R053","R5382","H9313","Z6827","Z1331","J0100"],"date":["2026-03-08","2026-03-04","2026-03-22","2026-02-12","2026-05-01","2026-05-01","2026-05-01","2026-05-01","2026-05-01","2026-05-01","2025-08-26","2025-08-26","2025-08-26","2025-08-26","2025-08-26","2025-08-26","2025-08-26","2025-08-26","2026-03-12","2026-02-05","2025-08-26","2026-02-05","2026-02-12","2026-02-12","2026-02-12","2025-09-02","2025-01-14","2024-09-07","2024-08-01","2024-08-01","2024-08-01","2025-01-14"],"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":[["","","TRAZODONE HCL","","","Select","Select",""],["","","NORTRIPTYLINE HCL","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","BENZONATATE","","","Select","Select",""],["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","AZELASTINE HCL","","","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":""}]}]}