{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Yvonne Obrien","gend":1,"currentgend":"","add":"93 PURCHASE ST","city":"MIDDLEBORO","state":"MA","zip":"02346","dob":"1977-11-07","age":"","mstatus":"","insh":"C0033986801","cliId":"","pno":"5085251464","cno":"","email":"","ename":"","eno":"","pphy":"Robert  Fruggiero","ppno":"5089739600","pcpadd":"1030 President Ave, Ste 1004","pcpcity":"Fall River","pcpstate":"MA","pcpzip":"02720","pcpcounty":"","pcpid":"","pcpname":"Southcoast Physicians Group, Inc","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"93 PURCHASE ST","madd2":"","madd3":"","mcity":"MIDDLEBORO","mstate":"MA","mzip":"02346","pcpfaxno":"","pcpnpi":"1649620683","currentgendcomment":"","pphycomment":"","uniqueid":"146347901","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R200","R7989","E1140","E1169","I10","H539","Z794","E785","E119","E1165","R99","I2510","E66811","I214","E782","M7910","M353","D72829","F17200","Z1231","Z0000","Z1211","E663","R208","H538","E871","I161","F17210","Z880","E669","Z6830","I213","Z79899","Z7982","Z7902","R519","I119","Z716","Z124","R87610","Z1151","R233","Z0184","I517","Z720","R739","Z6829","Z713","Z7182","Z01419","R001","Z9861","Z955","I160","I249","E113213","H2513","H5213","Z01411","N907"],"date":["2026-04-23","2026-03-05","2026-04-09","2026-04-09","2026-05-25","2026-04-09","2026-04-09","2026-04-09","2026-05-30","2026-05-14","2026-04-15","2026-04-06","2025-11-13","2025-11-19","2025-11-19","2025-08-28","2025-08-28","2025-08-28","2026-03-05","2025-12-03","2025-08-28","2025-09-08","2025-08-28","2026-03-05","2025-04-17","2025-03-29","2025-03-31","2025-04-16","2025-03-29","2025-03-29","2025-03-29","2025-03-28","2025-03-28","2025-03-28","2025-03-28","2025-03-28","2025-03-28","2025-03-28","2025-05-07","2025-05-07","2025-05-07","2025-06-19","2025-06-19","2025-03-29","2025-03-29","2025-03-28","2025-04-04","2025-04-04","2025-04-04","2025-04-04","2025-03-31","2025-04-16","2025-03-31","2025-03-28","2025-03-28","2025-04-30","2025-04-30","2025-04-30","2025-05-07","2025-05-07"],"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":[["","","ASPIRIN EC","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","FREESTYLE LITE TEST STRIP","","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","PRASUGREL HCL","","","Select","Select",""],["","","EASY TOUCH ALCOHOL PREP PADS","","","Select","Select",""],["","","NANO 2ND GEN PEN NEEDLE","","","Select","Select",""],["","","FREESTYLE LANCETS","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","FREESTYLE LIBRE 3 PLUS SENSOR","","","Select","Select",""],["","","WEGOVY","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ALCOHOL PREP PADS","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","MOUNJARO","","","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":""}]}]}