{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Anna Cipriani","gend":1,"currentgend":"","add":"49 TRANFAGLIA AVE","city":"LYNN","state":"MA","zip":"01905","dob":"1994-06-26","age":"","mstatus":"","insh":"C0030784600","cliId":"","pno":"6172818688","cno":"","email":"","ename":"","eno":"","pphy":"Sondra S Crosby","ppno":"6174145951","pcpadd":"801 Massachusetts Ave","pcpcity":"Boston","pcpstate":"MA","pcpzip":"02118","pcpcounty":"","pcpid":"","pcpname":"Evans Medical Foundation, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"49 TRANFAGLIA AVE","madd2":"","madd3":"","mcity":"LYNN","mstate":"MA","mzip":"01905","pcpfaxno":"","pcpnpi":"1275599847","currentgendcomment":"","pphycomment":"","uniqueid":"140371550","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":["N912","Z3480","O219","R5383","Z124","Z1151","Z3401","O3680X0","Z3481","Z1332","Z3A08","O358XX0","O09211","Z3682","Z3482","Z23","O09622","Z3A28","O26843","Z391","O6014X0","Z370","O43123","O691XX0","O700","O76","O99824","Z3A37","Z3493","Z3A36","O43103","O4202","O709","Z3403","O80","O43893"],"date":["2025-10-09","2025-10-07","2025-10-23","2025-10-09","2025-10-09","2025-10-09","2025-10-09","2025-10-22","2025-11-07","2026-03-02","2025-10-23","2026-01-23","2025-11-24","2025-11-24","2026-03-02","2026-03-09","2026-03-09","2026-03-09","2026-04-08","2026-03-03","2024-08-13","2024-08-13","2024-08-13","2024-08-13","2024-08-13","2024-08-13","2024-08-13","2024-08-13","2024-08-02","2024-08-08","2024-08-08","2024-08-13","2024-08-13","2024-08-08","2024-08-13","2024-08-13"],"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":[]},{"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":""}]}]}