{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jennifer Jarrett","gend":1,"currentgend":"","add":"11 PATRICIA ST","city":"EAST FALMOUTH","state":"MA","zip":"02536","dob":"1977-04-26","age":"","mstatus":"","insh":"C0027947500","cliId":"","pno":"7743580421","cno":"","email":"","ename":"","eno":"","pphy":"Victoria  Sharaf","ppno":"5087718350","pcpadd":"150 Ansel Hallet Rd","pcpcity":"West Yarmouth","pcpstate":"MA","pcpzip":"02673","pcpcounty":"","pcpid":"","pcpname":"Medical Affiliates of Cape Cod, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"11 PATRICIA ST","madd2":"","madd3":"","mcity":"EAST FALMOUTH","mstate":"MA","mzip":"02536","pcpfaxno":"","pcpnpi":"1952808156","currentgendcomment":"","pphycomment":"","uniqueid":"134659450","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":["N186","Z992","N2581","D631","N189","E8339","R1033","Z87441","I517","I340","I120","Z79899","Z4901","N19","E8351","E876","I10","D649","I252","R9431","Z136","Z01818","N939","I770","I159","I1310","G8918","T82858D","T82858A","Z0389","T82590A","I440","I129","Y838","T82868D","T82868A","Z23","Z7682","E441","R99","N051","E8720","N179","D6959","E8770","D509","Z91148","Z111"],"date":["2026-03-31","2026-03-31","2026-03-31","2026-03-14","2026-03-28","2026-03-31","2025-07-29","2025-07-29","2025-08-01","2025-08-01","2026-03-25","2026-03-25","2025-07-29","2025-07-29","2025-08-01","2025-08-01","2026-03-25","2026-03-25","2026-03-24","2026-03-24","2025-09-19","2026-03-16","2025-10-23","2026-03-24","2025-10-15","2025-11-17","2025-11-17","2026-03-24","2026-03-25","2026-03-24","2026-03-25","2026-03-24","2026-03-24","2026-03-24","2026-03-25","2026-03-25","2026-03-07","2026-03-16","2025-11-17","2026-03-24","2025-07-29","2025-07-29","2025-07-29","2025-07-29","2025-07-29","2025-07-29","2025-07-29","2025-08-08"],"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":[["","","CARVEDILOL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","CALCITRIOL","","","Select","Select",""],["","","VITAMIN D2","","","Select","Select",""],["","","CALCIUM ACETATE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","NIFEDIPINE ER","","","Select","Select",""],["","","SEVELAMER CARBONATE","","","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":""}]}]}