{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Safia S Jamil","gend":1,"currentgend":"","add":"36 THOMAS AVE","city":"ATTLEBORO","state":"MA","zip":"02703","dob":"1991-02-22","age":"","mstatus":"","insh":"C0033615200","cliId":"","pno":"5084465994","cno":"","email":"","ename":"","eno":"","pphy":"Suyin  Lee","ppno":"5087615650","pcpadd":"562 Washington St","pcpcity":"South Attleboro","pcpstate":"MA","pcpzip":"02703","pcpcounty":"","pcpid":"","pcpname":"Family Medicine Associates of South Attleboro, PC","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"36 THOMAS AVE","madd2":"","madd3":"","mcity":"ATTLEBORO","mstate":"MA","mzip":"02703","pcpfaxno":"","pcpnpi":"1851331383","currentgendcomment":"","pphycomment":"","uniqueid":"145543450","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":["T23009A","T7840XA","R99","R29898","B009","N979","M79641","R110","F17290","R079","J069","R200","Z87891","M25531","M25532","F419","Z01419","N912","O200","N898","Z0189","Z331","Z3A09","Z3A13","O26892","Z3A14","R109","Z79899","E039","Z3A17","Z3A25","R7302","F411","F3181","T23202A","X150XXA","J029","Z3202","L299","K148","R21","J310","J3089","J3081","J301","Z91013","Z0000","Z13220","F39","Z131","Z049","H5213","R259","R202","M79631","M79632","M6281","R42","R531","R258","R9402","R0781","Z3141","Z113","Z114","Z1159","E281","E282","E559","H9201","M79652","Z31430","Z124","O359XX0","O99891","L709","E663","Z6829","Z3A01","O209","Z3481","O09522","Z3689","O09529","O0990","M9903","M5387","M9904","M9905","M9902","M62830","M5459"],"date":["2024-10-10","2024-12-25","2026-02-28","2025-05-13","2025-06-24","2025-08-14","2025-08-03","2025-09-20","2025-05-17","2025-05-17","2025-03-14","2025-03-14","2025-03-14","2025-04-05","2025-04-05","2025-05-01","2025-08-14","2025-08-29","2025-10-21","2025-09-24","2026-01-21","2025-10-29","2025-10-03","2025-10-29","2025-11-04","2025-11-04","2025-11-04","2025-11-04","2025-11-26","2025-11-26","2026-01-21","2026-01-29","2026-01-12","2026-01-12","2024-10-10","2024-10-10","2025-06-26","2024-12-12","2024-12-13","2024-12-25","2025-06-25","2024-12-19","2025-01-08","2025-01-08","2025-01-08","2025-01-08","2025-01-16","2025-02-03","2025-01-16","2025-07-03","2025-01-16","2025-02-13","2025-03-06","2025-03-18","2025-04-05","2025-04-05","2025-03-18","2025-05-01","2025-05-14","2025-07-15","2025-05-19","2025-05-17","2025-07-09","2025-07-03","2025-07-03","2025-07-03","2025-08-13","2025-07-03","2025-07-03","2025-06-26","2025-07-30","2025-08-14","2025-08-14","2025-10-29","2025-09-20","2025-09-20","2025-09-20","2025-09-20","2025-09-20","2025-10-21","2025-10-09","2025-12-12","2025-12-12","2025-12-12","2025-12-12","2026-01-07","2026-01-07","2026-01-07","2026-01-07","2026-01-07","2026-01-07","2026-01-20"],"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":[["","","PREDNISONE","","","Select","Select",""],["","","EPINEPHRINE","","","Select","Select",""],["","","OLANZAPINE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","QUETIAPINE FUMARATE","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","METOCLOPRAMIDE HCL","","","Select","Select",""],["","","DOXYLAMINE SUCC-PYRIDOXINE HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","TERCONAZOLE","","","Select","Select",""],["","","WIXELA INHUB","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","CEFADROXIL","","","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":""}]}]}