{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Steven Hoffman","gend":0,"currentgend":"","add":"4 NATHANIEL ST","city":"HAVERHILL","state":"MA","zip":"01830","dob":"1963-07-03","age":"","mstatus":"","insh":"C0012395900","cliId":"","pno":9782732880,"cno":"","email":"","ename":"","eno":"","pphy":"Christopher R Lambert","ppno":9785213270,"pcpadd":"1 Park Way,","pcpcity":"Haverhill","pcpstate":"MA","pcpzip":"01830","pcpcounty":"","pcpid":"","pcpname":"Partners Community Physicians Organization Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"4 NATHANIEL ST","madd2":"","madd3":"","mcity":"HAVERHILL","mstate":"MA","mzip":"01830","pcpfaxno":"","pcpnpi":1396146742,"currentgendcomment":"","pphycomment":"","uniqueid":79264450,"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":["R99","E782","E8770","I10","F418","E119","I480","Z95810","I4720","J986","Z952","Z4502","R200","N6341","N6489","R921","R928","M5450","G8929","N200","R531","M539","K529","D72829","Z79899","I2510","N6310","R92321","Z98890","N281","N270","N390","Z0000","Z125","M419","M438X6","R1030","K625","K644","R202","L989","M47816","K5901","R310","N400","K6389","N202","R319","K5900","R933","N644","R92341"],"date":["2025-12-05","2024-07-31","2024-12-02","2025-12-05","2024-07-03","2025-12-05","2025-12-27","2025-03-21","2025-03-21","2024-08-03","2024-08-03","2024-11-03","2025-07-04","2024-07-10","2024-06-19","2024-06-19","2024-07-15","2025-07-04","2025-07-04","2025-09-10","2025-06-02","2025-06-02","2025-07-10","2025-07-10","2025-07-10","2025-03-21","2024-06-19","2024-06-19","2025-03-21","2025-07-10","2024-09-18","2024-11-12","2025-10-16","2025-10-16","2024-01-11","2024-01-11","2025-01-23","2025-11-12","2025-02-27","2025-07-04","2025-04-30","2025-07-31","2025-11-09","2025-09-10","2025-07-10","2025-07-10","2025-07-10","2025-09-10","2025-11-12","2025-11-12","2024-07-15","2024-07-15"],"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":[["","","MEXILETINE HCL","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","CIPROFLOXACIN 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":""}]}]}