{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Douglas Fribush","gend":0,"currentgend":"","add":"80 CAYUGA AVE","city":"MASHPEE","state":"MA","zip":"02649","dob":"1962-02-24","age":"","mstatus":"","insh":"C0019779300","cliId":"","pno":"5085392110","cno":"","email":"","ename":"","eno":"","pphy":"Kristy K Brown","ppno":"5084777090","pcpadd":"107 Commercial St","pcpcity":"Mashpee","pcpstate":"MA","pcpzip":"02649","pcpcounty":"","pcpid":"","pcpname":"Community Health Center of Cape Cod","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"80 CAYUGA AVE","madd2":"","madd3":"","mcity":"MASHPEE","mstate":"MA","mzip":"02649","pcpfaxno":"","pcpnpi":"1417939661","currentgendcomment":"","pphycomment":"","uniqueid":"98178600","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","Z1211","K5730","K648","K635","D120","D123","F332","F39","F411","F32A","Z0101","E119","H2513","H5203","H52203","H524","Z0001","E118","R351","E66812","F314","F419","I10","E782","H9193","H9313","Z6835","Z23","L853","R1031","R1032","F1220","Z860100","F3181","E669"],"date":["2026-05-29","2026-04-24","2026-04-24","2026-04-24","2026-04-24","2026-04-24","2026-04-24","2025-11-20","2025-12-05","2025-11-20","2025-11-20","2025-08-19","2025-08-19","2025-08-19","2025-08-19","2025-08-19","2025-08-19","2025-08-28","2026-04-24","2025-08-28","2025-12-05","2026-03-12","2025-08-28","2026-04-24","2025-12-05","2025-08-28","2025-08-28","2025-12-05","2025-12-05","2025-12-05","2025-12-05","2025-12-05","2026-03-12","2026-04-24","2024-10-03","2024-10-17"],"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":[["","","REXULTI","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","TRINTELLIX","","","Select","Select",""],["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","METHYLPHENIDATE ER","","","Select","Select",""],["","","METHYLPHENIDATE HCL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","QUETIAPINE FUMARATE","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","LITHIUM CARBONATE","","","Select","Select",""],["","","VRAYLAR","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","LAMOTRIGINE","","","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":""}]}]}