{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Maria Gonzalez","gend":1,"currentgend":"","add":"9 OREGON AVE","city":"LAWRENCE","state":"MA","zip":"01841","dob":"1960-03-07","age":"","mstatus":"","insh":"C0008527700","cliId":"","pno":"9787011483","cno":"","email":"","ename":"","eno":"","pphy":"Nicholas A Weida","ppno":"9786860090","pcpadd":"34 Haverhill St","pcpcity":"Lawrence","pcpstate":"MA","pcpzip":"01841","pcpcounty":"","pcpid":"","pcpname":"Greater Lawrence Family Health Center","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"APT 1","add3":"","madd1":"9 OREGON AVE","madd2":"APT 1","madd3":"","mcity":"LAWRENCE","mstate":"MA","mzip":"01841","pcpfaxno":"","pcpnpi":"1215298344","currentgendcomment":"","pphycomment":"","uniqueid":"67907950","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":["R99","R079","G4700","M810","I10","M25511","M70922","G248","Z1231","R92323","M25531","R030","Z5321","H26492","E785","Z98890","M65332","M654","M85431","R072","R9431","R011","E782","J984","M8580","M26622","M79641","M79642","Z2821","Z0189","R42","M19041","M19042","M85842","E538","M2669","Z23","M898X1","I491","R112","M19011","M19012","R1110","M62838","M542","G8929","R6884","M85852","H6505","K644"],"date":["2026-04-17","2026-03-17","2025-09-09","2025-09-09","2026-05-28","2026-05-28","2025-09-24","2025-08-26","2025-10-01","2025-10-01","2026-03-02","2026-03-17","2026-03-17","2025-09-11","2025-09-09","2025-10-01","2026-03-19","2026-03-02","2025-12-01","2026-03-17","2026-02-26","2026-02-26","2026-02-26","2026-03-17","2025-01-31","2025-04-28","2024-12-04","2024-12-04","2024-12-04","2024-12-04","2025-03-04","2024-12-06","2024-12-06","2024-12-06","2025-03-04","2025-03-04","2025-06-04","2025-06-04","2025-03-21","2024-08-12","2025-03-21","2025-03-21","2024-08-13","2024-12-10","2024-12-10","2024-12-10","2024-12-10","2025-01-31","2024-08-13","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":[["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ASPIRIN EC","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","LOSARTAN-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","BACLOFEN","","","Select","Select",""],["","","ZOLPIDEM TARTRATE","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","Select","Select",""],["","","FOLIC ACID","","","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":""}]}]}