{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Maureen Mcdaniel","gend":1,"currentgend":"","add":"15 ROCKY HILL RD","city":"BREWSTER","state":"MA","zip":"02631","dob":"1965-12-13","age":"","mstatus":"","insh":"C0031577400","cliId":"","pno":"8282314126","cno":"","email":"","ename":"","eno":"","pphy":"Susan J Syty","ppno":"5084321400","pcpadd":"710 Route 28","pcpcity":"Harwich Port","pcpstate":"MA","pcpzip":"02646","pcpcounty":"","pcpid":"","pcpname":"Outer Cape Health Services","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"15 Rocky Hill Road","madd2":"","madd3":"","mcity":"Brewster","mstate":"MA","mzip":"02631","pcpfaxno":"","pcpnpi":"1053631523","currentgendcomment":"","pphycomment":"","uniqueid":"141629700","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","Z23","K912","I10","E785","G4733","E569","Z9884","E6601","Z903","Z6832","E66811","Z8669","Z0000","E66813","D229","E119","Z6841","D485","L821","L814","D1801","E669","Z7182","Z79899","Z713","D2372","L918","E6609","C44319","S61201A","F339","E7800","Z01818","K219","Z6842","E88810","Z9989","Z888","F509","E559","F330","R590","R7303","K760","G4730","E66812","Z6837"],"date":["2026-02-11","2026-02-11","2026-02-03","2026-05-04","2026-05-04","2026-02-11","2025-10-27","2026-05-04","2026-02-03","2026-02-03","2026-02-03","2026-05-04","2026-05-04","2025-08-20","2026-02-11","2025-08-20","2026-02-11","2026-02-11","2025-11-03","2025-11-03","2025-11-03","2025-11-03","2025-11-04","2025-11-04","2025-11-04","2025-12-17","2025-11-03","2025-11-03","2025-12-17","2026-01-27","2026-01-16","2026-02-11","2026-02-11","2025-01-04","2025-06-18","2025-01-31","2025-04-23","2025-04-23","2025-04-23","2025-03-27","2025-03-14","2024-07-16","2024-07-16","2025-06-18","2025-01-28","2025-06-18","2025-06-18","2025-06-18"],"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":[["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","LOSARTAN-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","CITALOPRAM HBR","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","DOXAZOSIN MESYLATE","","","Select","Select",""],["","","ZEPBOUND","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","CEPHALEXIN","","","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":""}]}]}