{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Don B Flowers","gend":0,"currentgend":"","add":"29 Birch Pond Dr","city":"Saugus","state":"MA","zip":"01906","dob":"1966-12-15","age":"","mstatus":"","insh":"C0034830300","cliId":"","pno":"7812451234","cno":"","email":"","ename":"","eno":"","pphy":"Gary  Pransky","ppno":"6178468622","pcpadd":"52 Crest Ave","pcpcity":"Winthrop","pcpstate":"MA","pcpzip":"02152","pcpcounty":"","pcpid":"","pcpname":"Hallmark Health Medical Associates","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"29 Birch Pond Dr","madd2":"","madd3":"","mcity":"Saugus","mstate":"MA","mzip":"01906","pcpfaxno":"","pcpnpi":"1124102637","currentgendcomment":"","pphycomment":"","uniqueid":"147648400","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":["R99","I10","Z1211","E88810","E782","Z91030","N486","D122","K644","K648","Z860100","G4730","E66811","Z6831","Z85038","M2391","M2392","R739","R6882","D126","K760","M25561","N529","G4733","Z23","E6609","Z6834","H04123","H5203","H52223","H524","Z0000","Z125","Z1331","Z1339","E7841","L989","M546","R7989","Z6830","M170","M25562","M1711","M1712","E66813","Z789","E6601","G4710","E291","Z9189","Z6836","E66812","G8929","R161","Z87891"],"date":["2026-05-29","2026-05-21","2025-11-14","2025-12-01","2026-04-29","2026-04-29","2026-04-29","2025-11-14","2025-11-14","2025-11-14","2025-11-14","2025-11-14","2026-04-29","2025-11-14","2025-11-14","2026-02-02","2026-02-02","2025-10-20","2026-01-22","2026-01-22","2026-04-29","2026-04-29","2026-04-29","2026-05-14","2025-10-20","2026-04-29","2025-10-20","2025-10-17","2025-10-17","2025-10-17","2025-10-17","2026-01-22","2026-01-22","2026-01-22","2026-01-22","2026-04-29","2026-01-22","2026-01-22","2026-04-29","2026-04-13","2026-04-22","2025-02-26","2025-02-10","2025-02-26","2025-03-04","2025-03-04","2025-03-12","2025-04-09","2025-04-25","2025-01-13","2025-01-13","2025-01-13","2025-01-13","2025-01-20","2025-01-20"],"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":[["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","ZEPBOUND","","","Select","Select",""],["","","IRBESARTAN","","","Select","Select",""],["","","GAVILYTE-G","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","EPINEPHRINE","","","Select","Select",""],["","","PENTOXIFYLLINE","","","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":""}]}]}