{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Christine A Sparks","gend":1,"currentgend":"","add":"35 GRAPE ST","city":"NEW BEDFORD","state":"MA","zip":"02740","dob":"1973-03-10","age":"","mstatus":"","insh":"C0031047600","cliId":"","pno":"5082873845","cno":"","email":"","ename":"","eno":"","pphy":"Alan J Weinshel","ppno":"7749927499","pcpadd":"275 Allen St, Ste 101","pcpcity":"New Bedford","pcpstate":"MA","pcpzip":"02740","pcpcounty":"","pcpid":"","pcpname":"Southcoast Cardiology LLC","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"35 GRAPE ST","madd2":"","madd3":"","mcity":"NEW BEDFORD","mstate":"MA","mzip":"02740","pcpfaxno":"","pcpnpi":"1164479143","currentgendcomment":"","pphycomment":"","uniqueid":"140678500","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":["I10","E7800","R99","F419","J329","Z713","E782","Z8639","E663","J069","R739","F418","N200","I340","R109","R509","Z1231","Z01419","Z124","M9901","M542","M9903","M4696","M9902","M549","R519","R42","R202","R61","R0602","Z87891","O24419","E669","Z6828","Z79899","Z7182","K7581","Z1339","Z6826","R200","G479","H52223","H524","N393","K769","R310","K5730"],"date":["2026-01-09","2026-05-27","2026-03-31","2025-09-22","2025-11-24","2025-10-02","2025-10-02","2025-10-02","2026-03-17","2025-11-24","2025-08-04","2025-08-04","2025-08-04","2025-08-04","2025-09-23","2025-09-23","2025-09-26","2025-10-22","2025-10-22","2025-07-09","2025-07-09","2025-07-09","2025-07-09","2025-07-09","2025-07-09","2025-01-29","2025-01-07","2024-11-20","2024-11-20","2024-11-20","2024-11-20","2024-08-07","2025-04-07","2024-08-14","2024-08-14","2024-11-18","2025-06-19","2024-11-18","2024-11-18","2024-11-20","2025-04-15","2025-04-15","2025-04-15","2025-03-04","2025-03-04","2025-03-04","2025-03-10"],"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":[["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PROPRANOLOL HCL","","","Select","Select",""],["","","BUPROPION HCL SR","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","TRIAZOLAM","","","Select","Select",""],["","","BENZONATATE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","METFORMIN HCL ER","","","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":""}]}]}