{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Christopher Cluett","gend":0,"currentgend":"","add":"49 PERKINS ST","city":"GLOUCESTER","state":"MA","zip":"01930","dob":"1966-03-03","age":"","mstatus":"","insh":"C0042359100","cliId":"","pno":"9782908207","cno":"","email":"","ename":"","eno":"","pphy":"Victor  Carabba","ppno":"9782837580","pcpadd":"298 Washington St, Fl 4","pcpcity":"Gloucester","pcpstate":"MA","pcpzip":"01930","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":"49 PERKINS ST","madd2":"","madd3":"","mcity":"GLOUCESTER","mstate":"MA","mzip":"01930","pcpfaxno":"","pcpnpi":"1386673184","currentgendcomment":"","pphycomment":"","uniqueid":"159400300","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":["R99","Z48815","Z98890","Z8719","K4020","K458","R634","E1165","R9720","E291","R197","Z1211","D128","K648","R194","R1314","K2980","K222","K219","K3189","K2289","Z800","I10","E7800","Z794","K8689","Z13220","Z0000","Z23","Z1331","Z139","E785","E119","R1310","Z860102","N401","R3912","K2090","R195","K2950","K6389","K629"],"date":["2026-05-18","2026-01-05","2026-01-05","2026-01-05","2026-01-05","2026-01-05","2026-04-16","2026-05-09","2026-03-03","2026-03-03","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-04-16","2026-05-09","2026-01-08","2026-01-08","2026-01-08","2026-01-08","2026-01-08","2026-02-02","2026-02-02","2026-02-02","2026-03-03","2026-03-03","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09"],"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":[["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","NANO 2ND GEN PEN NEEDLE","","","Select","Select",""],["","","TESTOSTERONE","","","Select","Select",""],["","","TESTOSTERONE CYPIONATE","","","Select","Select",""],["","","CREON","","","Select","Select",""],["","","TAMSULOSIN HCL","","","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":""}]}]}