{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jalenna L Morales","gend":1,"currentgend":"","add":"440 NORTH AVE","city":"HAVERHILL","state":"MA","zip":"01830","dob":"2000-05-25","age":"","mstatus":"","insh":"C0021593400","cliId":"","pno":"9784763174","cno":"","email":"","ename":"","eno":"","pphy":"Elise A Carpenter","ppno":"9786556652","pcpadd":"360 Merrimack St, Ste 9","pcpcity":"Lawrence","pcpstate":"MA","pcpzip":"01843","pcpcounty":"","pcpid":"","pcpname":"Kronos Health, PLLC","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"APT 146","add3":"","madd1":"440 NORTH AVE","madd2":"APT 146","madd3":"","mcity":"HAVERHILL","mstate":"MA","mzip":"01830","pcpfaxno":"","pcpnpi":"1134431257","currentgendcomment":"","pphycomment":"","uniqueid":"101351450","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","K219","R051","E282","F411","E6601","R21","E559","L732","L309","M79671","E669","K760","L400","D2262","B084","R070","R300","R5383","Z3202","Z6842","E063","D72829","F4321","R6889","Z832","E039","J0190","J09X2","R110","R519","R0981","Z23","G4733","Z0100","H5213","H52223","R509","L739","J3489","J343","R0982","J309","J342","E041","Z01411","R1031","R1032","M5450","R197","N912","M549","R1030"],"date":["2026-04-09","2026-05-12","2025-11-07","2026-05-18","2026-05-19","2026-03-30","2026-03-09","2026-05-06","2026-04-07","2026-05-06","2026-04-17","2025-11-14","2026-03-30","2025-07-01","2025-07-01","2025-08-10","2025-11-07","2025-08-10","2025-08-10","2025-08-10","2025-08-10","2025-09-03","2025-09-03","2025-08-27","2025-08-27","2025-08-27","2026-05-12","2025-10-23","2025-11-07","2025-11-07","2025-11-07","2025-11-07","2025-10-29","2025-10-29","2025-12-27","2025-12-27","2025-12-27","2025-11-07","2026-04-07","2026-04-17","2026-05-12","2026-05-12","2026-05-12","2026-05-12","2026-05-12","2025-05-06","2025-04-15","2025-04-15","2025-04-15","2025-04-15","2025-05-06","2025-04-15","2025-04-15"],"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":[["","","OMEPRAZOLE","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","CALCIPOTRIENE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","MEDROXYPROGESTERONE ACETATE","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","FLUCELVAX 2025-2026","","","Select","Select",""],["","","BENZONATATE","","","Select","Select",""],["","","PHENTERMINE HCL","","","Select","Select",""],["","","TOPIRAMATE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","CLINDAMYCIN PHOSPHATE","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","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":""}]}]}