{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Maria Garcia","gend":1,"currentgend":"","add":"91 SUMMER ST","city":"LAWRENCE","state":"MA","zip":"01840","dob":"1973-04-14","age":"","mstatus":"","insh":"C0031539300","cliId":"","pno":"3512281840","cno":"","email":"","ename":"","eno":"","pphy":"Patrick S Salemme","ppno":"9786892400","pcpadd":"700 Essex St","pcpcity":"Lawrence","pcpstate":"MA","pcpzip":"01841","pcpcounty":"","pcpid":"","pcpname":"Greater Lawrence Family Health Center","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"APT 8","add3":"","madd1":"91 SUMMER ST","madd2":"APT 8","madd3":"","mcity":"LAWRENCE","mstate":"MA","mzip":"01840","pcpfaxno":"","pcpnpi":"1124688551","currentgendcomment":"","pphycomment":"","uniqueid":"141610750","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","U071","E559","L218","M5450","R202","Z603","Z758","Z227","E6601","R7303","Z1211","S161XXA","R9089","M7918","K648","R195","R233","Z9049","Z9884","Z880","Z881","Z882","E66811","K760","G4733","E6609","R140","R7989","K5909","Z6833","Z72820","R3911","F4312","F410","Z029","Z0000","Z1231","Z23","E669","I83893","R490","R413","I739","R2243","L720","L659","H1045","R058","G629","F419","L309","B349","M542","Z79899","R635","K911","E66812","Z6835","R945","K5900","Z713","Z7182","Z6834","R5383","F331","R499","R030","L818","K130","R92323","L821","R42","Z9189","R519","R051","Z98890","R102","N83201","Z124","Z113","Z1151","R87810","Z0100","F1010","J9801","Z872","N950","Z1384","A6922","Z1239","L819","D225","R21","J302"],"date":["2026-03-05","2025-09-18","2026-03-04","2026-04-07","2026-04-13","2025-09-07","2025-11-19","2025-11-19","2025-08-07","2025-09-17","2026-03-04","2026-02-10","2026-03-04","2025-11-19","2025-11-19","2026-02-10","2026-02-10","2026-02-10","2026-02-10","2026-03-04","2026-02-10","2026-02-10","2026-02-10","2026-03-04","2026-03-04","2026-03-04","2026-03-04","2026-03-04","2026-03-04","2026-03-04","2026-03-04","2026-03-04","2026-04-30","2025-07-07","2025-07-07","2025-07-11","2025-09-24","2025-09-24","2025-09-24","2026-02-09","2026-02-09","2026-02-09","2026-03-04","2026-03-26","2026-03-26","2026-04-07","2026-04-07","2026-04-07","2024-07-16","2024-12-07","2024-09-17","2024-11-20","2025-01-29","2025-06-03","2024-09-08","2024-10-28","2025-03-17","2025-10-01","2025-10-01","2025-03-13","2025-03-17","2025-03-17","2025-03-17","2025-03-17","2025-06-03","2025-11-06","2024-12-07","2024-12-07","2024-08-20","2024-08-20","2024-08-09","2024-08-20","2024-09-17","2024-09-17","2024-11-20","2025-01-29","2025-03-13","2025-04-10","2025-04-10","2025-05-01","2025-05-01","2025-04-10","2025-04-10","2025-05-12","2024-05-15","2024-05-28","2024-07-06","2024-05-06","2024-03-05","2024-03-05","2024-03-05","2024-05-17","2024-05-17","2024-05-17","2024-05-28"],"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":[["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","PROMETHAZINE-DM","","","Select","Select",""],["","","LINZESS","","","Select","Select",""],["","","AMITRIPTYLINE HCL","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","WEGOVY","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","ZEPBOUND","","","Select","Select",""],["","","BENZONATATE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","VITAMIN D2","","","Select","Select",""],["","","BACLOFEN","","","Select","Select",""],["","","LUBIPROSTONE","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","VIVITROL","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","NALTREXONE HCL","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","ESTRING","","","Select","Select",""],["","","CLARAVIS","","","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":""}]}]}