{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Horacio A Barroso","gend":0,"currentgend":"","add":"239 AYER RD","city":"LITTLETON","state":"MA","zip":"01460","dob":"1962-05-12","age":"","mstatus":"","insh":"C0034250900","cliId":"","pno":"6177971391","cno":"","email":"","ename":"","eno":"","pphy":"Victoria  Gray","ppno":"9784490282","pcpadd":"788 Boston Rd","pcpcity":"Groton","pcpstate":"MA","pcpzip":"01450","pcpcounty":"","pcpid":"","pcpname":"Revere Medical of Massachusetts, P.C.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"LOT 34","add3":"","madd1":"239 AYER RD","madd2":"LOT 34","madd3":"","mcity":"LITTLETON","mstate":"MA","mzip":"01460","pcpfaxno":"","pcpnpi":"1245939933","currentgendcomment":"","pphycomment":"","uniqueid":"146654550","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["Portuguese"]],"comment":[[]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N202","E785","Z79899","R002","R42","Z125","R7303","Z719","Z559","R0602","R350","R109","M79632","Z03823","M79602","M5442","M5441","G8929","K921","T7840XA","R0601","K5730","N200","K429","K648","K6289","R590","R1084","R351","R3911","M5117","M47817","N4281","N132","N201","N400","N401","E782","R99","K644","R8271","M5450","Z1211","Z23"],"date":["2026-04-14","2026-04-14","2026-04-14","2025-08-25","2025-07-17","2025-07-17","2025-10-14","2025-08-29","2025-07-17","2025-10-21","2025-11-12","2025-08-29","2025-10-08","2025-10-08","2025-10-08","2025-10-14","2025-10-14","2025-10-14","2025-10-14","2025-10-21","2025-10-21","2025-11-14","2026-04-09","2026-04-06","2025-11-14","2025-11-14","2025-11-14","2025-11-22","2025-12-01","2025-12-01","2025-12-05","2025-12-05","2025-11-22","2026-04-06","2026-04-14","2026-04-17","2026-04-17","2026-04-06","2026-05-27","2025-11-14","2026-04-09","2025-05-08","2025-05-08","2025-05-08"],"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":[["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LIDOCAINE","","","Select","Select",""],["","","CITALOPRAM HBR","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","FINASTERIDE","","","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":""}]}]}