{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Carol a Tasha","gend":1,"currentgend":"","add":"135 union street","city":"yarmouth port","state":"MA","zip":"02675","dob":"1966-06-24","age":"","mstatus":"","insh":"C0034460500","cliId":"","pno":"7742697756","cno":"","email":"","ename":"","eno":"","pphy":"Patricia  Tucker","ppno":"5087785420","pcpadd":"735 Attucks Ln","pcpcity":"Hyannis","pcpstate":"MA","pcpzip":"02601","pcpcounty":"","pcpid":"","pcpname":"Daniel Driscoll-Neponset Health Center","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"135 union street","madd2":"","madd3":"","mcity":"yarmouth port","mstate":"MA","mzip":"02675","pcpfaxno":"","pcpnpi":"1225078892","currentgendcomment":"","pphycomment":"","uniqueid":"147135150","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":["R1084","K219","K5900","Z8719","R030","R9431","F17200","Z1211","R1030","J449","R1013","R942","R0609","Z825","J4540","Z8616","Z720","Z716","N949","N6489","Z0000","R918","N393","B002","R1085","Z2820","Z1231","I10","R0789","Z13220","K2100","R99","K029","M5450","Z122","F17210","D122","D124","K5730","K2970","R12","K640","J309","R053","M25552","H40013","S20361A","J4550","Z0100","H52223","H524","H2513","H5203"],"date":["2025-12-08","2026-03-17","2026-01-06","2025-12-08","2025-12-08","2026-02-08","2026-03-17","2026-05-08","2025-11-03","2026-03-17","2026-05-27","2025-12-23","2025-12-23","2025-12-23","2025-12-23","2025-12-23","2025-12-23","2025-12-23","2026-01-06","2026-01-06","2026-01-06","2026-01-06","2026-01-06","2026-05-11","2026-01-06","2026-01-06","2026-01-28","2026-03-17","2026-03-17","2026-03-17","2026-05-08","2026-05-12","2026-03-17","2025-09-13","2025-10-02","2025-10-20","2026-05-08","2026-05-08","2026-05-08","2026-05-08","2026-05-08","2026-05-08","2025-07-31","2025-07-31","2025-09-13","2025-10-17","2025-10-20","2025-02-18","2025-05-22","2025-05-22","2025-05-22","2025-05-22","2025-05-22"],"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":[["","","FLUTICASONE PROPIONATE HFA","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","POLYETHYLENE GLYCOL 3350","","","Select","Select",""],["","","BREZTRI AEROSPHERE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","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":""}]}]}