{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Raul Guzman","gend":0,"currentgend":"","add":"187 SUMNER ST","city":"EAST BOSTON","state":"MA","zip":"02128","dob":"1965-11-19","age":"","mstatus":"","insh":"C0032129500","cliId":"","pno":"8572044830","cno":"","email":"","ename":"","eno":"","pphy":"Monica  Vohra","ppno":"6172883230","pcpadd":"1353 Dorchester Ave","pcpcity":"Dorchester","pcpstate":"MA","pcpzip":"02122","pcpcounty":"","pcpid":"","pcpname":"DotHouse Health Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"APT 306","add3":"","madd1":"187 SUMNER ST","madd2":"APT 306","madd3":"","mcity":"EAST BOSTON","mstate":"MA","mzip":"02128","pcpfaxno":"","pcpnpi":"1003107541","currentgendcomment":"","pphycomment":"","uniqueid":"142742100","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":["R200","R42","I10","Z7982","Z85850","Z8673","E1165","L819","R600","E785","C73","E890","E113313","E113311","H2513","E291","I6381","M6281","G4733","R0683","Z6829","I63539","I639","G459","R29810","G9389","R011","E119","E7800","G939","E66811","E6609","Z6830","I160","R29818","I161","R001","R99","R110","H538","E039","E669","I2510"],"date":["2025-02-03","2025-02-03","2025-10-29","2025-02-02","2025-02-03","2025-02-03","2025-09-17","2025-08-14","2025-08-14","2025-10-29","2025-10-10","2025-08-14","2025-10-10","2025-09-17","2025-09-17","2025-10-10","2025-10-29","2025-10-29","2025-08-14","2024-08-07","2024-08-07","2024-08-21","2024-08-22","2024-08-22","2024-08-21","2024-08-22","2024-08-22","2025-02-11","2024-08-29","2024-10-01","2024-10-18","2024-10-18","2024-10-18","2025-02-03","2025-02-02","2025-02-02","2025-02-05","2026-02-27","2024-08-22","2024-08-22","2024-08-22","2024-08-22","2024-08-22"],"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":[["","","JARDIANCE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","FREESTYLE LITE TEST STRIP","","","Select","Select",""],["","","FREESTYLE LANCETS","","","Select","Select",""],["","","RYBELSUS","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","TESTOSTERONE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","ASPIRIN EC","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","SINGLE USE SWAB","","","Select","Select",""],["","","TRAZODONE 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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}