{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Margarita M Contreras","gend":1,"currentgend":"","add":"2 MUSEUM SQ","city":"LAWRENCE","state":"MA","zip":"01840","dob":"1962-10-27","age":"","mstatus":"","insh":"C0007103500","cliId":"","pno":"9786015735","cno":"","email":"","ename":"","eno":"","pphy":"Madhavi  Challagulla","ppno":"9787835000","pcpadd":"323 Lowell St","pcpcity":"Andover","pcpstate":"MA","pcpzip":"01810","pcpcounty":"","pcpid":"","pcpname":"Partners Community Physicians Organization Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"APT 810","add3":"","madd1":"2 MUSEUM SQ","madd2":"APT 810","madd3":"","mcity":"LAWRENCE","mstate":"MA","mzip":"01840","pcpfaxno":"","pcpnpi":"1023132800","currentgendcomment":"","pphycomment":"","uniqueid":"66587900","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["Spanish"]],"comment":[[]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0000","R0789","K2900","M542","M5412","M7711","E782","N762","R99","I10","Z1231","G8929","Z98891","Z9851","Z98890","Z8679","B009","R92323","M25511","M25521","M8589","Z0001","L80","E559","E785","D649","M7910","B029","M546","Z1159","Z114","J029","R519","R059"],"date":["2026-04-30","2026-04-14","2026-04-14","2026-04-23","2026-04-06","2026-04-06","2026-04-30","2025-10-27","2026-05-27","2026-02-10","2026-02-02","2026-03-31","2026-01-14","2026-01-14","2026-01-14","2026-01-14","2026-01-14","2026-02-02","2026-04-06","2026-04-06","2026-02-10","2026-02-10","2026-02-10","2026-02-10","2026-02-10","2026-02-10","2026-02-10","2026-02-10","2025-02-05","2025-02-05","2025-02-05","2025-02-05","2025-02-05","2025-02-05"],"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",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","BENZONATATE","","","Select","Select",""],["","","CLINDAMYCIN PHOSPHATE","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","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":""}]}]}