{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ryan E Grace","gend":1,"currentgend":"","add":"617 HYDE PARK AVE","city":"ROSLINDALE","state":"MA","zip":"02131","dob":"1988-09-24","age":"","mstatus":"","insh":"C0031604100","cliId":"","pno":"8573129560","cno":"","email":"","ename":"","eno":"","pphy":"Sarah  Sloan","ppno":"6172697500","pcpadd":"409 W Broadway","pcpcity":"South Boston","pcpstate":"MA","pcpzip":"02127","pcpcounty":"","pcpid":"","pcpname":"South Boston Community Health Center","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"APT 3","add3":"","madd1":"617 HYDE PARK AVE","madd2":"APT 3","madd3":"","mcity":"ROSLINDALE","mstate":"MA","mzip":"02131","pcpfaxno":"","pcpnpi":"1770719460","currentgendcomment":"","pphycomment":"","uniqueid":"141672350","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","E559","K50914","S161XXA","K650","K50014","Z7189","Z23","F17210","Z432","K5010","D518","Z01810","E876","K551","Z87891","K639","K50919","M533","M0760","K5080","Z800","Z0000","Z113","Z789","Z932","R6330","K9189","Z9189","K567","K6389","Z01419","K50819","Z980","K5140","Z30433","Z933"],"date":["2024-11-15","2025-02-18","2026-01-30","2025-02-28","2024-05-13","2024-10-02","2024-05-13","2024-05-21","2024-06-17","2024-11-13","2024-11-13","2025-02-18","2024-10-29","2024-11-13","2024-11-13","2026-01-30","2025-02-28","2025-02-28","2025-02-28","2025-02-28","2025-05-19","2025-05-19","2025-05-22","2025-05-22","2024-05-02","2024-11-20","2024-05-02","2024-05-02","2024-05-02","2024-05-02","2024-11-20","2025-05-20","2025-05-20","2025-05-19","2025-05-19","2025-05-22","2024-09-08"],"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":[["","","VITAMIN D2","","","Select","Select",""],["","","NALOXONE HCL","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","GAVILYTE-G","","","Select","Select",""],["","","LIDOCAINE","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","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":""}]}]}