{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jamal Halabi","gend":0,"currentgend":"","add":"710 MAIN ST","city":"WALTHAM","state":"MA","zip":"02451","dob":"1965-07-23","age":"","mstatus":"","insh":"C0021892200","cliId":"","pno":"9787643682","cno":"","email":"","ename":"","eno":"","pphy":"Brent A Fryling","ppno":"9787776544","pcpadd":"5 Federal St, Ste 1","pcpcity":"Danvers","pcpstate":"MA","pcpzip":"01923","pcpcounty":"","pcpid":"","pcpname":"Beth Israel Lahey Health Primary Care ,Inc","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"APT 422","add3":"","madd1":"710 MAIN ST","madd2":"APT 422","madd3":"","mcity":"WALTHAM","mstate":"MA","mzip":"02451","pcpfaxno":"","pcpnpi":"1053369611","currentgendcomment":"","pphycomment":"","uniqueid":"102199450","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":["E782","E1165","R99","I10","Z125","Z1211","Z1331","Z1339","Z0000","Z23","F5101","H35033","D563","H2513","K8020","K760","E6601","Z6836","Z0001","Z6838","Z9884","M79671","G8929","Z6835","Z7984","E66812"],"date":["2026-03-16","2026-05-22","2026-05-12","2026-03-16","2025-10-20","2025-10-28","2025-10-20","2025-10-20","2025-10-20","2025-10-20","2025-10-20","2025-10-20","2025-10-20","2025-10-20","2025-10-20","2025-10-20","2025-10-20","2025-10-20","2024-09-20","2024-09-20","2025-05-05","2025-03-14","2025-03-14","2025-05-05","2025-05-05","2024-12-05"],"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":[["","","ZEPBOUND","","","Select","Select",""],["","","DOXEPIN HCL","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","OZEMPIC","","","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":""}]}]}