{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Teresa Li","gend":1,"currentgend":"","add":"151 BEACH ST","city":"QUINCY","state":"MA","zip":"02170","dob":"1961-10-11","age":"","mstatus":"","insh":"C0008035001","cliId":"","pno":"3124797043","cno":"","email":"","ename":"","eno":"","pphy":"Qiyue  Hu","ppno":"6173183300","pcpadd":"435 Hancock St","pcpcity":"Quincy","pcpstate":"MA","pcpzip":"02171","pcpcounty":"","pcpid":"","pcpname":"South Cove Comm Health Center","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"APT 2","add3":"","madd1":"151 BEACH ST","madd2":"APT 2","madd3":"","mcity":"QUINCY","mstate":"MA","mzip":"02170","pcpfaxno":"","pcpnpi":"1699733089","currentgendcomment":"","pphycomment":"","uniqueid":"67262801","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R99","I10","G4700","L400","Z1283","A199","A150","C8203","Z5181","L4050","L409","E876","C8213","Z7184","B159","B54","M79671","M25561","M79672","M25562","G8929","E875","E039","J8410","I700","I7143","J479","R0683","G4733","R918","Z8611","R059","Z1231","Z1239","M170","M19071","M19072","M778","M7731","M7732","M2011","M2012","Z79899","I776","R5383","A159","D72819","E871","R519","R079","R000","I729","R0902","D689","D696","D62","I3139","A1889","I791","K660","K6389","R9431","Z862","Z792","Z16341","Z1211","R141","Z4682","J90","M1990","J9811","R911","J810","Z4689","R599","R112","K567","K828","M314","R6889","E041","K649","M79644","R051","D702","R110","R509","N390","D709","R42","R1084","C8210","R5081","Z16342","R002","R319","R310","K2900","N281","N200","K2990","K219","Z139","Z98890","Z09","Z8572","I7140","Z95828","Z8619","L608","E162","R590","E785","M79641","M79642","Z01419","H25813","Z5112","K2970","A158","R21","G478","R053","C821A","E569","E222","D849","Z227","Z8679","Z7982","G4730","I77811","Z79621","Z79890","C8200","Z880","Z888","R634","R0602","A319","C8290","D6959","D84821","E8339","H04129","I509","I110","R1310","R32","R197","Z1624","R531","R109","D6489","D701","T451X5A","D708"],"date":["2026-05-08","2026-04-15","2026-04-01","2025-07-16","2025-07-16","2025-08-02","2025-08-02","2025-08-02","2025-08-09","2026-04-02","2026-04-02","2025-10-09","2025-10-17","2025-11-03","2025-11-03","2025-11-03","2026-03-31","2026-03-31","2026-03-31","2026-03-31","2026-03-31","2025-12-31","2025-12-31","2026-01-02","2026-01-02","2026-03-13","2026-04-01","2026-04-15","2026-04-01","2026-04-02","2026-04-02","2026-04-02","2025-07-17","2025-07-17","2025-12-24","2025-12-24","2025-12-24","2025-12-24","2025-12-24","2025-12-24","2025-12-24","2025-12-24","2025-02-27","2025-03-07","2024-08-26","2025-04-15","2024-08-26","2025-04-18","2024-12-23","2024-08-29","2024-08-20","2024-07-28","2024-07-28","2024-07-28","2024-08-18","2024-07-28","2025-02-27","2024-07-25","2024-07-25","2024-07-25","2025-04-08","2024-10-10","2025-03-13","2025-01-23","2025-04-15","2025-02-27","2024-09-30","2024-07-24","2024-09-22","2024-07-19","2024-12-20","2024-07-25","2024-07-29","2024-07-22","2024-07-15","2024-08-01","2024-08-06","2024-07-20","2024-10-18","2024-11-27","2025-02-27","2024-11-12","2024-11-22","2024-11-21","2025-04-15","2025-03-17","2025-03-13","2024-12-19","2024-12-23","2024-12-20","2024-12-20","2024-12-22","2024-12-23","2024-12-23","2024-07-26","2025-01-28","2025-04-07","2025-02-04","2025-04-07","2025-04-09","2025-02-27","2025-03-07","2025-03-07","2025-03-07","2025-03-07","2024-10-18","2025-03-07","2025-03-07","2025-03-07","2025-04-03","2025-04-12","2025-04-09","2025-05-08","2025-06-13","2025-06-13","2025-06-25","2024-10-21","2025-02-12","2025-02-04","2024-12-23","2024-12-23","2024-12-23","2024-12-23","2024-12-23","2024-12-23","2025-02-27","2024-12-23","2024-12-23","2024-12-23","2025-02-27","2025-02-27","2025-02-27","2025-02-27","2025-02-27","2025-02-27","2025-02-27","2025-02-27","2024-07-03","2024-07-01","2024-07-12","2024-07-12","2024-07-12","2024-07-12","2024-07-12","2024-07-12","2024-07-12","2024-07-12","2024-07-12","2024-07-12","2024-07-12","2024-07-12","2024-07-12","2024-07-12","2024-08-18","2024-08-18","2024-08-18","2024-08-28"],"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":[["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","LINEZOLID","","","Select","Select",""],["","","PRETOMANID","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","RIFABUTIN","","","Select","Select",""],["","","ETHAMBUTOL HCL","","","Select","Select",""],["","","ASPIRIN","","","Select","Select",""],["","","PYRAZINAMIDE","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","ZOLPIDEM TARTRATE","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","ASPIRIN EC","","","Select","Select",""],["","","CALCIPOTRIENE","","","Select","Select",""],["","","LIDOCAINE","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","LOVASTATIN","","","Select","Select",""],["","","FLUCELVAX TRIVALENT 2024-2025","","","Select","Select",""],["","","NOVAVAX COVID 2024-2025 (EUA)","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","SOD SULF-POTASS SULF-MAG SULF","","","Select","Select",""],["","","OLANZAPINE","","","Select","Select",""],["","","CALCIPOTRIENE-BETAMETHASONE","","","Select","Select",""],["","","ORENCIA CLICKJECT","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","ZORYVE","","","Select","Select",""],["","","FLUBLOK 2025-2026","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","KETOCONAZOLE","","","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":""}]}]}