{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lauren M Bell","gend":1,"currentgend":"","add":"36 EDINBORO RD APT 3","city":"QUINCY","state":"MA","zip":"02169","dob":"1966-07-17","age":"","mstatus":"","insh":"C0019555600","cliId":"","pno":"8572367335","cno":"","email":"","ename":"","eno":"","pphy":"Jonathan M Pincus","ppno":"6178259660","pcpadd":"637 Washington St","pcpcity":"Dorchester","pcpstate":"MA","pcpzip":"02124","pcpcounty":"","pcpid":"","pcpname":"Codman Square Health Center","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"36 EDINBORO RD APT 3","madd2":"","madd3":"","mcity":"QUINCY","mstate":"MA","mzip":"02169","pcpfaxno":"","pcpnpi":"1043234099","currentgendcomment":"","pphycomment":"","uniqueid":"97340300","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","I4820","M79605","Z7689","E210","E042","C73","E559","Z124","Z1159","E119","I4891","E8352","E789","R7303","I10","E7800","R195","Z1231","M25561","F1121","F32A","Z113","M25562","G8929","R87618","R87810","B977","G4733","E1165","E6601","F331","F411","F439","E213","Z780","H2513","H18413","G514","Z83518"],"date":["2026-04-29","2025-08-13","2025-07-14","2025-07-15","2026-03-27","2025-09-18","2026-03-27","2026-03-27","2025-09-29","2025-09-29","2026-02-09","2026-03-23","2026-03-23","2026-03-12","2026-03-12","2026-03-23","2026-01-21","2026-03-23","2025-10-01","2025-09-29","2026-03-23","2025-09-29","2025-09-29","2025-09-29","2025-09-29","2025-09-29","2025-09-29","2026-02-09","2026-03-23","2026-03-23","2026-03-23","2026-04-13","2026-04-13","2026-04-13","2025-05-23","2025-05-23","2025-06-30","2025-06-30","2025-06-30","2025-06-30"],"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":[["","","FAMOTIDINE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","SOTALOL","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ZEPBOUND","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","METFORMIN 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":""}]}]}