{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Dakshabahen Patel","gend":1,"currentgend":"","add":"50 DEVOL AVE","city":"WESTPORT","state":"MA","zip":"02790","dob":"1967-03-10","age":"","mstatus":"","insh":"C0030878600","cliId":"","pno":"2019206436","cno":"","email":"","ename":"","eno":"","pphy":"Thaylon  Barreto","ppno":"5089739600","pcpadd":"1030 President Ave","pcpcity":"Fall River","pcpstate":"MA","pcpzip":"02720","pcpcounty":"","pcpid":"","pcpname":"Southcoast Physicians Group, Inc","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"50 DEVOL AVE","madd2":"","madd3":"","mcity":"WESTPORT","mstate":"MA","mzip":"02790","pcpfaxno":"","pcpnpi":"1811552169","currentgendcomment":"","pphycomment":"","uniqueid":"140562750","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":["R99","K219","I10","Z1231","M25562","G8929","Z96652","T8484XA","T8484XD","Z96651","Z471","Z96653","M1711","M25861","Z96642","M25462","E782","Z23","R7303","E559","E66811","Z6831","Z1389","Z1331","Z131","S8992XD","W19XXXD","T84038A","T84038D","Z96659","Z01818","Z01812","Z01810","E785","I129","N189","Z560","Z791","M1990","Z124","Z1151","Z1159","Z0189","H25813","H01001","E6609","M170","Z713","Z7182","Z6832","M25461","R9431","R079","R21","Z0001","L272","Z01419","L299","L900","L2089","L280","G8918"],"date":["2026-01-09","2025-09-10","2026-04-29","2025-08-18","2026-02-03","2025-09-22","2026-02-03","2025-10-30","2026-03-31","2026-03-31","2025-09-18","2025-09-30","2025-10-30","2025-07-10","2025-09-16","2025-10-30","2025-10-08","2025-10-08","2025-10-08","2025-10-08","2025-10-08","2025-10-08","2025-10-08","2025-10-08","2025-10-08","2025-10-30","2025-10-30","2025-11-14","2026-01-09","2026-01-09","2026-05-12","2024-08-20","2024-08-20","2024-09-26","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-26","2025-02-26","2025-02-26","2025-03-05","2025-03-05","2024-07-03","2024-07-03","2025-01-29","2024-07-29","2025-01-29","2025-01-29","2024-07-29","2024-10-29","2024-09-16","2024-09-16","2025-03-13","2025-01-29","2025-01-29","2025-02-26","2025-03-13","2025-02-26","2025-04-17","2025-04-17","2024-09-16"],"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":[["","","PREDNISONE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","VALSARTAN-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","ASPIRIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","NALOXONE HCL","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","MUPIROCIN","","","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":""}]}]}