{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Olga Paulino","gend":1,"currentgend":"","add":"21 BRUCE ST","city":"LAWRENCE","state":"MA","zip":"01841","dob":"1967-09-11","age":"","mstatus":"","insh":"C0017158200","cliId":"","pno":"9789020335","cno":"","email":"","ename":"","eno":"","pphy":"Jennifer  Wolf","ppno":"9786863017","pcpadd":"73D Winthrop Ave","pcpcity":"Lawrence","pcpstate":"MA","pcpzip":"01843","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":"21 BRUCE ST","madd2":"APT 1","madd3":"","mcity":"LAWRENCE","mstate":"MA","mzip":"01841","pcpfaxno":"","pcpnpi":"1316477177","currentgendcomment":"","pphycomment":"","uniqueid":"92688350","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":["N840","N950","E785","K219","Z79899","N6001","R92331","N393","R300","N952","G9389","R9082","J328","R3129","R350","R92321","H60391","S86911A","Z6832","J343","J302","H905","G4733","J329","J342","M1711","H903","Z9851","N939","Z23","D320","R928","R7611","E669","D329","R32","L299","J320","J322","G939","Z0000","R7303","Z809","R519","Z862","R92323","H60399","R99","J209","Z01818","R9389","M5442","M5450","F5101","B349","D110","Z1231","N6489","Z6833","M5416","R599","R070","R110","R051","Z1384","H409","R0981","G8929","R92333","N938","N6011","N6310","Z0100","N9489","Z1331","N3946"],"date":["2025-11-18","2025-11-18","2025-09-24","2025-09-24","2025-09-24","2026-05-05","2025-11-10","2026-04-09","2026-01-08","2026-04-09","2025-12-22","2025-12-22","2025-12-22","2026-04-09","2026-04-09","2026-05-05","2025-08-05","2025-08-05","2025-08-05","2026-01-08","2025-08-21","2026-01-08","2025-08-21","2025-09-10","2026-01-08","2025-09-15","2025-08-21","2025-11-18","2026-02-02","2025-09-15","2026-02-02","2026-02-02","2025-09-15","2026-02-02","2025-12-22","2025-11-18","2026-01-08","2026-01-08","2026-01-08","2025-12-22","2026-02-02","2026-02-02","2026-02-02","2026-04-25","2026-02-02","2026-05-05","2025-08-05","2026-02-02","2026-04-22","2025-09-17","2025-09-10","2024-07-22","2025-01-06","2024-09-28","2025-01-02","2024-07-10","2025-02-15","2025-04-14","2025-06-18","2024-08-12","2024-08-26","2025-01-02","2025-01-02","2025-01-02","2025-01-06","2025-01-06","2025-01-06","2025-01-06","2025-02-15","2025-02-15","2025-03-12","2025-03-12","2025-04-10","2025-04-14","2025-04-14","2025-06-18"],"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",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","NAPROXEN","","","Select","Select",""],["","","WEGOVY","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","PHENTERMINE HCL","","","Select","Select",""],["","","ESZOPICLONE","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","AMITRIPTYLINE HCL","","","Select","Select",""],["","","OFLOXACIN","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","CLOTRIMAZOLE-BETAMETHASONE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","VENTOLIN HFA","","","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":""}]}]}