{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Suly Smith","gend":1,"currentgend":"","add":"277 RIVER ST","city":"WALTHAM","state":"MA","zip":"02453","dob":"1972-07-07","age":"","mstatus":"","insh":"C0038489600","cliId":"","pno":"7812969422","cno":"","email":"","ename":"","eno":"","pphy":"Janis S Recto","ppno":"6176653600","pcpadd":"119 Windsor St","pcpcity":"Cambridge","pcpstate":"MA","pcpzip":"02139","pcpcounty":"","pcpid":"","pcpname":"Cambridge Public Health Commission","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"277 RIVER ST","madd2":"","madd3":"","mcity":"WALTHAM","mstate":"MA","mzip":"02453","pcpfaxno":"","pcpnpi":"1144435116","currentgendcomment":"","pphycomment":"","uniqueid":"152888400","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["Spanish"]],"comment":[[]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R99","J4540","N926","Z3202","D259","Z30431","N946","R1020","G8929","N939","Z23","H5203","H52203","H524","R7303","F332","D251","D252","N83292","Z975","F331","Z0000","Z124","Z1231","R5381","R5383","J302","R42","R112","H9311","L299","N920","R079"],"date":["2026-03-23","2026-01-27","2026-03-30","2025-07-21","2026-03-30","2026-03-30","2026-03-30","2026-03-09","2026-01-27","2026-01-27","2025-12-02","2025-12-06","2025-12-06","2025-12-06","2025-12-06","2026-01-27","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-04-17","2026-05-13","2026-05-13","2026-05-13","2026-05-13","2026-05-13","2025-05-08","2025-06-17","2025-05-31","2025-06-17","2025-06-17","2025-06-18","2025-05-31"],"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":[["","","ONDANSETRON ODT","","","Select","Select",""],["","","FLUTICASONE-SALMETEROL","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","LUPRON DEPOT","","","Select","Select",""],["","","IPOL","","","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":""}]}]}