{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Rasha T Arida","gend":1,"currentgend":"","add":"59 JEROME ST","city":"MEDFORD","state":"MA","zip":"02155","dob":"1983-02-16","age":"","mstatus":"","insh":"C0007083600","cliId":"","pno":"7815181013","cno":"","email":"","ename":"","eno":"","pphy":"Jean M Bakey","ppno":"7813380500","pcpadd":"195 Canal St","pcpcity":"Malden","pcpstate":"MA","pcpzip":"02148","pcpcounty":"","pcpid":"","pcpname":"Cambridge Public Health Commission","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"59 JEROME ST","madd2":"","madd3":"","mcity":"MEDFORD","mstate":"MA","mzip":"02155","pcpfaxno":"","pcpnpi":"1528354461","currentgendcomment":"","pphycomment":"","uniqueid":"66561900","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":["K529","R21","N921","R99","J0190","M549","N12","R112","N390","K219","R1032","J020","B9789","R000","R0602","R1084","J90","J9811","R10A2","N838","B354","J0110","H5789","N898","N6452","N6321","L739","Z23","N644","J029","E559","Z13220","Z131","N926","M533","N760","Z0000"],"date":["2026-05-09","2026-02-03","2026-02-19","2026-05-14","2026-04-24","2026-04-24","2026-05-14","2026-03-03","2026-05-09","2026-02-28","2026-03-03","2026-04-24","2026-04-24","2026-05-09","2026-05-11","2026-02-28","2026-05-11","2026-05-11","2026-05-09","2026-05-09","2025-05-12","2024-11-12","2024-11-14","2025-05-09","2025-05-14","2024-11-01","2024-10-07","2024-10-07","2024-11-01","2024-11-12","2024-12-06","2024-12-06","2024-12-06","2025-05-14","2025-05-12","2025-05-12","2025-05-14"],"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":[["","","KETOCONAZOLE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","POLYMYXIN B SUL-TRIMETHOPRIM","","","Select","Select",""],["","","VITAMIN D2","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","CEFPODOXIME PROXETIL","","","Select","Select",""],["","","GAVILAX","","","Select","Select",""],["","","EC-NAPROXEN","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","NALOXONE 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":""}]}]}