{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Melanie A Enos","gend":1,"currentgend":"","add":"55 SEABROOK RD","city":"HYANNIS","state":"MA","zip":"02601","dob":"1982-09-06","age":"","mstatus":"","insh":"C0040977600","cliId":"","pno":"7743603135","cno":"","email":"","ename":"","eno":"","pphy":"Stephanie  Delande","ppno":"5087719599","pcpadd":"94 Main St","pcpcity":"Hyannis","pcpstate":"MA","pcpzip":"02601","pcpcounty":"","pcpid":"","pcpname":"Duffy Health Center, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"55 SEABROOK RD","madd2":"","madd3":"","mcity":"HYANNIS","mstate":"MA","mzip":"02601","pcpfaxno":"","pcpnpi":"1245651322","currentgendcomment":"","pphycomment":"","uniqueid":"157330550","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":["F1421","R99","E063","F331","F4310","F3341","F1021","F1120","G4709","F419","F332","M79632","E039","F17210","Z79899","F5105","F1121","F1290","F1420","F99","G621","R41840","Z596","Z720","F411","F902","N3946","R251","F1990","Z8632","E66811","F1410","E6609","Z6833","R202","R29898","Z713","Z1231","Z7182","Z8673","Z13220","F1490","F1090","I10","R011","R7689","Z87898","Z9189","F1191","E236"],"date":["2025-11-06","2026-01-19","2026-05-23","2026-02-11","2026-03-04","2026-05-23","2026-05-31","2026-05-08","2026-04-21","2026-03-30","2026-05-28","2026-03-09","2026-03-09","2026-04-09","2026-03-30","2025-11-13","2026-03-04","2026-04-09","2025-11-13","2025-11-13","2026-03-30","2025-11-13","2025-11-13","2025-11-13","2026-05-07","2026-05-07","2025-11-12","2026-03-30","2026-04-09","2026-03-30","2026-03-30","2026-03-04","2026-03-30","2026-03-30","2026-03-30","2026-03-30","2026-03-16","2026-03-16","2026-03-16","2026-03-16","2026-03-30","2026-04-09","2026-04-09","2026-04-09","2026-04-09","2026-04-09","2026-04-09","2026-04-09","2026-04-09","2026-04-17"],"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":[["","","BACLOFEN","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","QUETIAPINE FUMARATE","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","CLOTRIMAZOLE","","","Select","Select",""],["","","FLUCELVAX 2025-2026","","","Select","Select",""],["","","BUPRENORPHINE-NALOXONE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","HYDROXYZINE PAMOATE","","","Select","Select",""],["","","CLONIDINE HCL","","","Select","Select",""],["","","REXULTI","","","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":""}]}]}