{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Julio C Dos Reis","gend":0,"currentgend":"","add":"4 Westgate Dr","city":"Woburn","state":"MA","zip":"01801","dob":"2001-05-09","age":"","mstatus":"","insh":"C0038115800","cliId":"","pno":"8572086153","cno":"","email":"","ename":"","eno":"","pphy":"Kenneth K Gerwick","ppno":"6176653000","pcpadd":"163 Gore St","pcpcity":"Cambridge","pcpstate":"MA","pcpzip":"02141","pcpcounty":"","pcpid":"","pcpname":"Cambridge Public Health Commission","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"Apt T6","add3":"","madd1":"4 Westgate Dr","madd2":"Apt T6","madd3":"","mcity":"Woburn","mstate":"MA","mzip":"01801","pcpfaxno":"","pcpnpi":"1497733752","currentgendcomment":"","pphycomment":"","uniqueid":"152406950","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":["R99","E1010","E039","E8339","E8341","E8351","E860","E871","E875","E876","E878","K5900","N179","Z794","E109","R9431","B3321","E1310","Z452","R0602","E1110","T68XXXA","R7402","R000","X31XXXA","R7309","I10","I4581","R040","J301"],"date":["2026-05-26","2026-05-15","2026-05-06","2025-12-27","2025-12-27","2025-12-27","2025-12-27","2025-12-27","2025-12-27","2025-12-27","2025-12-28","2025-12-27","2025-12-28","2025-12-27","2026-05-01","2025-12-29","2025-12-29","2025-12-30","2025-12-27","2025-12-27","2025-12-27","2025-12-27","2025-12-27","2026-01-05","2025-12-27","2025-12-27","2026-01-05","2026-02-13","2025-05-12","2025-05-12"],"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":[["","","ULTRA-FINE PEN NEEDLE","","","Select","Select",""],["","","ALCOHOL SWAB","","","Select","Select",""],["","","FIASP FLEXTOUCH","","","Select","Select",""],["","","FREESTYLE LANCETS","","","Select","Select",""],["","","FREESTYLE LITE TEST STRIP","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","BAQSIMI","","","Select","Select",""],["","","DEXCOM G7 SENSOR","","","Select","Select",""],["","","DEXCOM G7 RECEIVER","","","Select","Select",""],["","","UNIFINE PENTIPS","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","IPOL","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","HUMALOG","","","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":""}]}]}