{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael R Iannantuoni","gend":0,"currentgend":"","add":"17 PURITAN RD","city":"TAUNTON","state":"MA","zip":"02780","dob":"1964-10-22","age":"","mstatus":"","insh":"C0030644500","cliId":"","pno":"5088892721","cno":"","email":"","ename":"","eno":"","pphy":"Kerry  Girard","ppno":"5086973677","pcpadd":"545 Bedford St","pcpcity":"Bridgewater","pcpstate":"MA","pcpzip":"02324","pcpcounty":"","pcpid":"","pcpname":"Signature Healthcare Medical Group, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"17 PURITAN RD","madd2":"","madd3":"","mcity":"TAUNTON","mstate":"MA","mzip":"02780","pcpfaxno":"","pcpnpi":"1871541045","currentgendcomment":"","pphycomment":"","uniqueid":"139997700","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":["G4733","R99","L74519","R053","J9811","R091","J301","E669","Z6838","Z87891","M25531","Z125","E7800","K862","K760","I10","M79601","E6601","Z6839","R42","M5450","M542","R29898","S46819A","E66812","Z0000","Z9989","Z98890","Z888","Z880","Z803","Z8042","Z8249","Z7951","D225","L821","L814","Z808","Z9109","J342","G4730","R0789","J3489","Q181","R1010","K219","R7309","Z79899","M25561","G8929","L309","Z0100","R1011","R1012","R1033","R140","H9193","K769","L0889","H903","N401","R338","I771","M549","L988","K869","N400","M67412","M5412","M19012","S46912A","N529","Z791","Z840","Z9181"],"date":["2026-05-12","2026-01-12","2025-12-11","2025-08-14","2026-02-17","2026-02-17","2026-04-09","2026-02-25","2025-11-05","2026-02-25","2026-05-04","2025-11-05","2026-05-04","2025-12-03","2025-12-26","2025-12-26","2026-01-20","2026-02-17","2026-02-25","2026-03-24","2025-07-31","2025-12-10","2025-09-15","2025-09-15","2025-11-05","2025-11-05","2026-01-07","2026-02-25","2026-02-09","2026-01-07","2026-02-25","2026-01-07","2026-02-25","2026-02-17","2026-02-09","2026-02-09","2026-02-09","2026-02-09","2026-02-17","2026-02-25","2026-02-25","2026-02-25","2026-04-09","2025-06-09","2024-07-18","2024-07-18","2024-11-04","2025-02-17","2025-04-18","2025-05-08","2024-07-10","2024-07-23","2024-07-18","2024-07-18","2024-07-18","2025-02-17","2024-07-25","2024-07-25","2024-08-08","2024-08-19","2024-08-30","2024-08-30","2024-08-30","2024-07-18","2024-11-14","2024-07-18","2024-07-18","2024-09-26","2025-01-10","2024-11-15","2024-11-15","2025-01-08","2025-02-17","2025-02-17","2025-05-08"],"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":[["","","BETAMETHASONE DIPROPIONATE","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","CLINDAMYCIN PHOSPHATE","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","NABUMETONE","","","Select","Select",""],["","","GLYCOPYRROLATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","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":""}]}]}