{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Roger W Stewart","gend":0,"currentgend":"","add":"8 Laurel Ln","city":"Forestdale","state":"MA","zip":"02644","dob":"1966-02-14","age":"","mstatus":"","insh":"C0039932900","cliId":"","pno":"9259980252","cno":"","email":"","ename":"","eno":"","pphy":"Barbara  Robinson","ppno":"7745523201","pcpadd":"770 Main St","pcpcity":"Osterville","pcpstate":"MA","pcpzip":"02655","pcpcounty":"","pcpid":"","pcpname":"Medical Affiliates of Cape Cod, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"8 Laurel Ln","madd2":"","madd3":"","mcity":"Forestdale","mstate":"MA","mzip":"02644","pcpfaxno":"","pcpnpi":"1003953415","currentgendcomment":"","pphycomment":"","uniqueid":"155089350","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":["J309","R99","I4891","Z1211","J342","K621","D122","K5730","R079","J343","G4733","I10","Z880","Z91041","J3089","N401","R0981","J301","Z0000","E781","I4820","G5691","D696","I480","L821","L814","D1801","L918","Z7189","L820","L538","L299","L570","Z01810","I77810","Z8249","Z79899","H2513","Z98890","H5213","K635","Z01818","I4510","G5621","H2511","H43813","I4719"],"date":["2025-10-24","2026-01-23","2026-02-08","2025-12-01","2026-01-05","2025-12-01","2025-12-01","2025-12-01","2025-12-31","2026-01-05","2026-01-05","2026-01-05","2026-01-05","2026-01-05","2025-11-07","2025-12-11","2025-12-12","2025-10-20","2025-10-23","2025-10-23","2025-10-09","2025-10-23","2025-11-25","2025-12-26","2025-10-24","2025-10-24","2025-10-24","2025-10-24","2025-10-24","2025-10-24","2025-10-24","2025-10-24","2025-10-24","2025-12-31","2025-12-31","2025-12-31","2025-12-31","2025-12-09","2025-12-09","2025-12-09","2025-12-01","2025-12-26","2025-12-24","2026-01-08","2026-01-20","2026-01-12","2026-01-08"],"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":[["","","TAMSULOSIN HCL","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","FLECAINIDE ACETATE","","","Select","Select",""],["","","FLUBLOK 2025-2026","","","Select","Select",""],["","","SPIKEVAX 2025-2026 (12Y UP)","","","Select","Select",""],["","","IMIQUIMOD","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","DILTIAZEM 24HR ER (CD)","","","Select","Select",""],["","","SOD SULF-POTASS SULF-MAG SULF","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","ASPIRIN EC","","","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":""}]}]}