{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Yolkania Lopez","gend":1,"currentgend":"","add":"78 BYRON AVE","city":"LAWRENCE","state":"MA","zip":"01841","dob":"1980-06-20","age":"","mstatus":"","insh":"C0030738500","cliId":"","pno":"9789608721","cno":"","email":"","ename":"","eno":"","pphy":"Stella  Athanasopoulos","ppno":"9789468480","pcpadd":"575 Turnpike St, Ste 22","pcpcity":"North Andover","pcpstate":"MA","pcpzip":"01845","pcpcounty":"","pcpid":"","pcpname":"Community Medical Associates, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"78 BYRON AVE","madd2":"","madd3":"","mcity":"LAWRENCE","mstate":"MA","mzip":"01841","pcpfaxno":"","pcpnpi":"1811506397","currentgendcomment":"","pphycomment":"","uniqueid":"140225700","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["Spanish"]],"comment":[[]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R99","N898","D708","Z79899","N6001","R92333","Z0000","Z0184","R300","M79672","M722","R92331","R1032","M76822","N6315","M25551","M25552","J4520","L600","H7401","K219","G4700","J343","H6981","R1312","J384","M26609","Z01419","Z1239","Z0001","L816","F5101","J302","S92251A"],"date":["2026-02-11","2025-09-15","2025-11-26","2025-11-26","2025-10-02","2025-10-02","2026-02-04","2026-02-04","2026-02-04","2025-08-04","2025-08-04","2025-10-02","2026-02-18","2024-08-29","2024-09-05","2025-06-04","2025-06-04","2025-06-04","2025-01-22","2025-01-22","2025-06-04","2025-01-22","2025-03-13","2025-03-13","2025-03-13","2025-03-13","2025-03-13","2025-04-21","2025-04-21","2025-06-04","2025-06-04","2025-06-04","2025-06-04","2024-08-19"],"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":[["","","ZOLPIDEM TARTRATE","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","DULERA","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","FLUCELVAX 2025-2026","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","METRONIDAZOLE","","","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":""}]}]}