{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"William Major","gend":0,"currentgend":"","add":"40 CHIPPEWA DR","city":"BUZZARDS BAY","state":"MA","zip":"02532","dob":"1969-07-26","age":"","mstatus":"","insh":"C0032091401","cliId":"","pno":"7742711136","cno":"","email":"","ename":"","eno":"","pphy":"Divjot K Sooch","ppno":"5088940400","pcpadd":"1215 Broadway","pcpcity":"Raynham","pcpstate":"MA","pcpzip":"02767","pcpcounty":"","pcpid":"","pcpname":"Signature Healthcare Medical Group, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"40 CHIPPEWA DR","madd2":"","madd3":"","mcity":"BUZZARDS BAY","mstate":"MA","mzip":"02532","pcpfaxno":"","pcpnpi":"1275731853","currentgendcomment":"","pphycomment":"","uniqueid":"142591401","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R99","E119","M109","M720","M85841","S99921A","S99922A","I10","E7800","Z7984","Z7985","Z87891","I639","Z5181","Z973","Z888","M79641","M79642","R937","Z1331","Z98890","Z841","M7671","M7672","Q6671","Q6672","R52","M7731","M2142","Z8673","Z8249","E785","Z122","Z79899","D649","R748","E1136","H25013","H43392","H5203","H52223","H524","Z0000","Z23","F17210","K760","N289","N642"],"date":["2026-05-14","2026-05-17","2026-02-19","2026-03-16","2025-08-04","2025-09-10","2025-09-10","2026-02-27","2026-02-27","2025-09-11","2025-09-11","2026-02-27","2026-02-27","2026-02-27","2026-02-27","2026-02-27","2025-08-11","2025-08-11","2025-08-04","2025-09-10","2025-09-11","2025-09-10","2025-09-11","2025-09-11","2025-09-11","2025-09-11","2025-09-11","2025-09-10","2025-09-10","2026-02-27","2026-02-27","2024-11-26","2024-10-22","2024-11-26","2024-11-26","2024-11-26","2025-04-29","2025-04-29","2025-04-29","2025-04-29","2025-04-29","2025-04-29","2025-06-05","2025-06-05","2025-06-05","2024-10-22","2024-10-22","2024-10-22"],"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":[["","","JANUVIA","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","VENLAFAXINE HCL ER","","","Select","Select",""],["","","FENOFIBRATE","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","XIAFLEX","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","IBUPROFEN","","","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":""}]}]}