{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Christopher Vanbeeck","gend":0,"currentgend":"","add":"5 SHAMROCK LN","city":"BUZZARDS BAY","state":"MA","zip":"02532","dob":"1978-02-18","age":"","mstatus":"","insh":"C0034604600","cliId":"","pno":"5085246788","cno":"","email":"","ename":"","eno":"","pphy":"Eric E Johnson","ppno":"5087460754","pcpadd":"45 Resnik Rd, Ste 202","pcpcity":"Plymouth","pcpstate":"MA","pcpzip":"02360","pcpcounty":"","pcpid":"","pcpname":"Eric E. Johnson","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"5 SHAMROCK LN","madd2":"","madd3":"","mcity":"BUZZARDS BAY","mstate":"MA","mzip":"02532","pcpfaxno":"","pcpnpi":"1184610958","currentgendcomment":"","pphycomment":"","uniqueid":"147418250","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":["E781","R99","M4807","K219","T148XXA","M5450","G8929","R519","E7800","Z131","M25551","G2401","S92912A","R683","Z23","Z0389","Z98890","I10","M5451","R079","H60502","K2100","R197","K2289","K640","K5730","K2090","H9202","H938X2","L539","R194","Z9189","K2970","K529","R5382","J321"],"date":["2026-03-08","2026-04-02","2026-04-18","2026-02-27","2025-10-03","2026-02-20","2026-02-20","2026-04-09","2026-03-24","2026-03-24","2025-10-03","2025-10-03","2025-10-03","2025-10-03","2025-10-03","2025-10-03","2026-02-20","2026-04-09","2026-05-13","2026-04-09","2024-12-07","2025-02-05","2025-02-05","2025-02-05","2025-02-05","2025-02-05","2025-02-05","2024-12-07","2024-12-07","2024-12-07","2025-02-05","2025-02-05","2025-02-05","2025-05-01","2025-05-01","2025-05-01"],"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":[["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","OFLOXACIN","","","Select","Select",""],["","","AUSTEDO","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","ONDANSETRON 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":[]}},{"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":""}]}]}