{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Anthony Gianoulis","gend":0,"currentgend":"","add":"16 TAMAROCK TER","city":"STONEHAM","state":"MA","zip":"02180","dob":"2002-03-13","age":"","mstatus":"","insh":"C0038390300","cliId":"","pno":"6179629861","cno":"","email":"","ename":"","eno":"","pphy":"Arantxa  Lewis","ppno":"7816626400","pcpadd":"88 Montvale Ave","pcpcity":"Stoneham","pcpstate":"MA","pcpzip":"02180","pcpcounty":"","pcpid":"","pcpname":"Beth Israel Lahey Health Primary Care ,Inc","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"16 TAMAROCK TER","madd2":"","madd3":"","mcity":"STONEHAM","mstate":"MA","mzip":"02180","pcpfaxno":"","pcpnpi":"1831658079","currentgendcomment":"","pphycomment":"","uniqueid":"152759250","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":["F640","Z2981","R99","J101","N3001","K921","E669","Z6830","F419","F32A","K5730","K648","Z79624","Z79899","G2581","G4710","R030","Z13220","J301","K625","R059","L659","E66811","Z6833","K649","K5790","L700","L739","L219","J3089","J3081","H1045","Z1331","Z1339","Z0000","Z139","Z6834","Z206"],"date":["2026-05-29","2026-01-27","2026-05-22","2025-12-30","2026-03-26","2026-01-20","2026-01-05","2026-01-05","2026-03-26","2026-01-05","2026-01-05","2026-01-05","2026-01-05","2026-01-05","2026-03-24","2026-03-24","2026-03-26","2026-03-24","2026-05-12","2025-11-04","2025-12-30","2026-03-26","2026-03-26","2025-12-30","2026-01-20","2026-01-20","2026-01-27","2026-01-27","2026-01-27","2026-03-17","2026-03-17","2026-03-10","2026-03-24","2026-03-24","2026-03-24","2026-03-24","2026-03-26","2025-05-20"],"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":[["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","VENLAFAXINE HCL ER","","","Select","Select",""],["","","MINOXIDIL","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","CLINDAMYCIN PHOSPHATE","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","EMTRICITABINE-TENOFOVIR DISOP","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","","","Select","Select",""],["","","PROGESTERONE","","","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":""}]}]}