{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ali M Yassine","gend":0,"currentgend":"","add":"1136 HILLTOP DR","city":"WALPOLE","state":"MA","zip":"02081","dob":"1958-02-07","age":"","mstatus":"","insh":"C0019304200","cliId":"","pno":"7819758271","cno":"","email":"","ename":"","eno":"","pphy":"Abdulfatah O Elshaar","ppno":"7817697070","pcpadd":"95 Chapel St, Ste 2D","pcpcity":"Norwood","pcpstate":"MA","pcpzip":"02062","pcpcounty":"","pcpid":"","pcpname":"Medical Associates of New England","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1136 HILLTOP DR","madd2":"","madd3":"","mcity":"WALPOLE","mstate":"MA","mzip":"02081","pcpfaxno":"","pcpnpi":"1821045550","currentgendcomment":"","pphycomment":"","uniqueid":"96854650","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["Arabic"]],"comment":[[]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E1165","D649","I10","E7849","R0789","I25810","K5900","Z951","E785","R079","E119","Z0000","R9439","R99","L03313","R000","I517","J90","I2510","I240","R269","E1129","E113211","E113212","H43812","H2511","H179","R9431","R0602","Z1211","D122","D123","D125","K648","Z79899","Z7984","I25110","E7800","E11319","D62","D696","J9811","E861","I959","E8339","D72829","E663","Z6825","Z87891","Z7982","Z794","Z603","Z789","H3500","B09","R195","Z122","M79671","H6120","R6884","M62838","E139","K635","M25511","M7551","Z7189","M7541","M47812","I259","J984","I77810","Z4659","Z01810","I6522","I444","I25119","I2081","I25118","I4510","Z0189","R918","G8918","E559"],"date":["2026-05-26","2025-12-04","2025-12-04","2025-12-04","2025-12-03","2026-04-28","2026-01-21","2026-05-29","2026-05-06","2026-03-19","2026-03-19","2026-04-28","2025-11-26","2026-03-06","2025-08-28","2025-07-01","2025-07-03","2025-07-11","2025-07-17","2025-08-25","2025-08-25","2025-08-25","2025-07-25","2025-07-25","2025-07-25","2025-07-25","2025-07-25","2025-08-04","2025-08-11","2025-03-03","2025-03-03","2025-03-03","2025-03-03","2025-03-03","2025-06-17","2025-06-17","2025-06-17","2025-06-27","2025-06-17","2025-06-17","2025-06-17","2025-06-17","2025-06-17","2025-06-17","2025-06-17","2025-06-17","2025-06-30","2025-06-17","2025-06-17","2025-06-17","2025-06-17","2025-06-17","2024-10-03","2025-06-27","2024-08-12","2024-11-12","2024-11-12","2024-11-12","2025-02-18","2025-02-18","2025-02-18","2025-03-03","2025-03-03","2025-06-12","2025-04-07","2025-04-22","2025-05-19","2025-06-06","2025-06-23","2025-06-24","2025-06-18","2025-06-18","2025-06-21","2025-06-21","2025-06-27","2025-06-30","2025-06-26","2025-06-24","2025-06-27","2025-06-24","2025-06-26","2025-06-24","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":[["","","RYBELSUS","","","Select","Select",""],["","","FREESTYLE LITE TEST STRIP","","","Select","Select",""],["","","FREESTYLE LANCETS","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","GLIMEPIRIDE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","ASPIRIN","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","METFORMIN HCL ER","","","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":""}]}]}