{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Tracie M Smith","gend":1,"currentgend":"","add":"24 ROGERS ST","city":"FAIRHAVEN","state":"MA","zip":"02719","dob":"1968-06-07","age":"","mstatus":"","insh":"C0017210400","cliId":"","pno":"5089994618","cno":"","email":"","ename":"","eno":"","pphy":"Than Than  Win","ppno":"5089926553","pcpadd":"874 Purchase St","pcpcity":"New Bedford","pcpstate":"MA","pcpzip":"02740","pcpcounty":"","pcpid":"","pcpname":"Greater New Bedford Community Health Center","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"24 ROGERS ST","madd2":"","madd3":"","mcity":"FAIRHAVEN","mstate":"MA","mzip":"02719","pcpfaxno":"","pcpnpi":"1447298054","currentgendcomment":"","pphycomment":"","uniqueid":"92738250","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":["L309","R99","H9313","I10","J45909","K219","D331","E782","J029","G509","L237","J329","G894","M150","R52","G8929","M0580","D333","H938X1","R2689","H9041","Z01818","E669","E785","H9191","H9319","G43909","G629","Z79899","Z7951","Z6832","M542","M546","Z20822","G501","H93291","H6591","H9071","D329","H903","H9311","F411","R262","M722","M79671","J3089","H93A1","R519","J301","H93A3","D3610","R4189","G4700","Z0001","Z139","F331","D126","K760","M797","D259","Z23","Z1331","D320","D332","Z01810","R1310","R051","E7800","J0100","J101","J0190","R058","R29898","M76811","Z86018","Z1231","R053","R0602","R5383","R748","R7989","Z0100","M159","G5603","R768","E66811","E6609","N852","J0140","L814","L708","D2371","L821","Z713","Z7182","G5601","G5602","M7701","R42","R200","R202","R269","R55","N200","D1771","R1011","R1031","G43719","G35","M25562","M160","M25551","M25561"],"date":["2025-07-14","2026-01-30","2026-01-30","2026-02-26","2025-11-11","2026-05-11","2025-12-11","2026-02-26","2026-03-22","2026-05-21","2026-05-26","2025-11-07","2025-08-13","2025-08-13","2025-08-13","2025-08-13","2025-08-13","2026-05-11","2025-12-09","2026-05-11","2026-05-11","2025-10-30","2025-11-13","2025-11-13","2025-11-13","2025-11-13","2025-11-13","2025-11-13","2025-11-11","2025-11-11","2025-11-11","2026-03-17","2026-03-17","2026-03-22","2026-05-11","2026-05-11","2026-02-02","2026-02-02","2026-02-02","2026-02-02","2026-02-02","2026-02-26","2025-12-06","2025-12-06","2025-12-06","2025-11-07","2025-08-14","2025-08-06","2025-08-18","2025-08-14","2025-09-17","2025-09-17","2025-09-17","2025-09-18","2026-02-26","2026-02-26","2025-09-18","2026-02-26","2026-02-26","2025-09-18","2025-09-18","2026-02-26","2026-02-05","2025-11-13","2025-11-03","2026-02-26","2025-01-21","2025-05-25","2025-04-03","2025-01-28","2025-01-27","2025-02-20","2025-04-21","2025-04-21","2024-11-13","2025-01-14","2025-07-03","2025-04-17","2025-04-17","2025-07-05","2025-06-03","2024-07-22","2024-08-27","2025-02-28","2024-10-21","2024-10-21","2024-10-21","2024-11-13","2025-01-28","2025-02-20","2025-02-20","2025-02-20","2025-02-20","2025-04-17","2025-04-17","2024-06-02","2024-06-02","2024-06-02","2024-07-03","2024-02-29","2024-07-03","2024-07-03","2024-07-03","2024-08-04","2024-08-04","2024-08-04","2024-08-04","2024-05-14","2024-02-29","2024-05-22","2024-05-22","2024-05-22","2024-05-22"],"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":[["","","BENZONATATE","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","CLINDAMYCIN PHOSPHATE","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","LEVETIRACETAM","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","PAROXETINE 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":""}]}]}