{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Shane M Frisby","gend":0,"currentgend":"","add":"56 COBBLESTONE RD","city":"BARNSTABLE","state":"MA","zip":"02630","dob":"1981-03-03","age":"","mstatus":"","insh":"C0031968700","cliId":"","pno":"5082804474","cno":"","email":"","ename":"","eno":"","pphy":"Munir  Ahmed","ppno":"5084777090","pcpadd":"107 Commercial St","pcpcity":"Mashpee","pcpstate":"MA","pcpzip":"02649","pcpcounty":"","pcpid":"","pcpname":"Community Health Center of Cape Cod","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"56 COBBLESTONE RD","madd2":"","madd3":"","mcity":"BARNSTABLE","mstate":"MA","mzip":"02630","pcpfaxno":"","pcpnpi":"1851367312","currentgendcomment":"","pphycomment":"","uniqueid":"142411500","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":["E7849","R5383","F901","Z7689","E66812","G4733","K219","E785","F411","F331","F32A","E66811","Z6831","F418","D225","D2271","D2272","L821","L570","Z113","R99","F321","Z6835","Z713","G4730","E6601","D2261","D2262","B078","L814","J343","J384","R0683","R7301","R7989","F419","R41840","Z5181","Z638","Z302","R197","R112"],"date":["2026-01-29","2025-10-23","2026-01-29","2025-11-06","2026-04-14","2026-04-14","2025-11-24","2026-04-14","2026-03-19","2025-11-24","2026-01-29","2026-01-29","2026-01-29","2026-03-13","2026-02-18","2026-02-18","2026-02-18","2026-02-18","2026-02-18","2026-04-27","2026-05-14","2025-12-15","2025-10-22","2025-08-06","2025-08-06","2025-08-06","2025-08-19","2025-08-19","2025-08-19","2025-08-19","2025-09-12","2025-09-12","2025-09-12","2025-10-23","2025-10-22","2025-10-23","2025-10-23","2025-10-23","2024-11-18","2024-10-16","2025-01-20","2025-01-20"],"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",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","ZEPBOUND","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","ATOVAQUONE","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","CLINDAMYCIN PHOSPHATE","","","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":""}]}]}