{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Fabiola E Paredes","gend":1,"currentgend":"","add":"116 BRADFORD ST","city":"LAWRENCE","state":"MA","zip":"01840","dob":"1996-11-05","age":"","mstatus":"","insh":"C0016879900","cliId":"","pno":"9786014019","cno":"","email":"","ename":"","eno":"","pphy":"Tito  Joaquin","ppno":"9785578800","pcpadd":"500 Merrimack St","pcpcity":"Lawrence","pcpstate":"MA","pcpzip":"01843","pcpcounty":"","pcpid":"","pcpname":"Partners Community Physicians Organization Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"APT 1","add3":"","madd1":"116 BRADFORD ST","madd2":"APT 1","madd3":"","mcity":"LAWRENCE","mstate":"MA","mzip":"01840","pcpfaxno":"","pcpnpi":"1164983201","currentgendcomment":"","pphycomment":"","uniqueid":"92349550","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":["R1031","R1012","Z01818","Q676","Z0183","F4310","Z87442","Z9049","Z98890","F330","F411","Z789","E8352","Z0000","R779","R770","R140","Z23","N281","Z0001","M954","S299XXA","I361","J982","J948","J9811","Z01419","Z3040","Z124","M6289","Z3046","R99","Z01810","R942","N6310","R87610","N644","R1319","N6001","I493","R2242","R39198","Z803","R079","R1011","N289","Q625","K8050","R102","N1330","Q638","N854","K819","K811","K824","R109","R112"],"date":["2025-12-09","2025-12-09","2025-12-11","2026-01-08","2025-12-11","2025-12-12","2025-12-12","2025-12-12","2026-01-08","2026-04-29","2026-05-13","2025-07-11","2025-08-12","2025-08-12","2025-08-12","2025-08-12","2025-09-10","2025-08-12","2025-08-12","2025-08-12","2025-10-22","2025-09-29","2025-10-22","2025-12-14","2025-12-14","2025-12-14","2026-01-12","2026-01-12","2026-01-12","2026-01-12","2026-02-18","2026-05-25","2025-10-22","2025-12-02","2024-07-08","2024-07-08","2024-08-09","2024-08-09","2024-09-19","2024-08-09","2024-08-09","2024-08-09","2024-08-09","2025-01-03","2025-06-06","2025-04-07","2025-04-07","2025-06-06","2025-06-13","2025-06-05","2025-06-05","2025-06-05","2025-06-06","2025-06-06","2025-06-06","2025-06-09","2025-06-09"],"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":[["","","IBUPROFEN","","","Select","Select",""],["","","OXYCODONE HCL","","","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":""}]}]}