{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Yahirys Rojas De Tejada","gend":1,"currentgend":"","add":"107 LEXINGTON ST","city":"LAWRENCE","state":"MA","zip":"01841","dob":"1979-10-03","age":"","mstatus":"","insh":"C0008774701","cliId":"","pno":"9784296962","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":"107 LEXINGTON ST","madd2":"APT 1","madd3":"","mcity":"LAWRENCE","mstate":"MA","mzip":"01841","pcpfaxno":"","pcpnpi":"1215298344","currentgendcomment":"","pphycomment":"","uniqueid":"68186051","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","B20","I10","N179","I160","R600","I129","N182","R7989","Z79899","Z21","Z7984","H579","I161","N02B1","N189","M7989","Z1231","Z0000","M7122","M79604","N02B9","M2550","H1789","H524","B582","B589","R7401","B5889","N1831","R809","R42","Q283","N289","N3289","Z8669","K429","M47814","M8958","R590","C7931","M1712","D259","G939","G9389","N119","E669","R3129","Z8673","N2589","N83201","Z6833","I69398","D496","I6389","R900","H538","N1832","D709","D649","N261","H5213","K838","N838","K2289","H5461","I6523","R768","Z23","R591","N1419","I639","L270","B370","N1830","R9389","Q2112","N059","N186","N02B2","N269","D690","Z789","H65192","N009","Z1211","Z7982","G936","N170","E8720","E871","D638","N02B5","T368X5A","H53123","Z636","Z758","R937"],"date":["2026-03-05","2026-05-21","2026-04-10","2026-02-27","2026-02-27","2026-02-27","2026-02-27","2026-02-27","2026-02-27","2026-02-27","2026-03-01","2026-02-27","2025-10-14","2026-02-25","2026-02-27","2026-02-27","2026-02-27","2026-02-25","2026-02-25","2026-02-27","2026-02-27","2026-03-01","2024-10-30","2024-10-29","2024-10-29","2025-04-14","2025-03-25","2025-02-26","2025-03-02","2025-03-25","2025-03-25","2024-09-16","2024-09-02","2024-09-15","2024-09-03","2024-09-03","2024-09-03","2024-09-03","2024-09-03","2024-09-16","2024-09-05","2024-09-05","2024-09-16","2024-09-19","2024-09-06","2024-09-03","2024-09-03","2024-09-22","2024-09-03","2024-10-21","2024-09-03","2024-09-03","2024-09-03","2024-09-06","2024-09-03","2024-09-06","2024-09-16","2024-09-23","2024-09-23","2024-09-23","2024-09-20","2024-09-17","2024-09-16","2024-09-16","2024-09-16","2024-09-20","2024-09-23","2024-10-28","2025-04-02","2024-09-13","2024-09-20","2024-09-23","2024-10-21","2024-10-21","2025-03-02","2024-10-04","2024-10-04","2024-09-03","2024-09-05","2024-09-20","2024-09-20","2024-09-20","2024-12-19","2025-01-05","2025-03-01","2025-04-02","2024-09-02","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16"],"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":[["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","OLMESARTAN MEDOXOMIL","","","Select","Select",""],["","","BIKTARVY","","","Select","Select",""],["","","ATOVAQUONE","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","JULUCA","","","Select","Select",""],["","","TARPEYO","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","VALSARTAN","","","Select","Select",""],["","","NIFEDIPINE ER","","","Select","Select",""],["","","SULFADIAZINE","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","GABAPENTIN","","","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":""}]}]}