{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jhonny E Rodriguez","gend":0,"currentgend":"","add":"50 San Juan St","city":"Boston","state":"MA","zip":"02118","dob":"1962-02-01","age":"","mstatus":"","insh":"C0042871000","cliId":"","pno":"8572373761","cno":"","email":"","ename":"","eno":"","pphy":"Joanne M Murabito","ppno":"6176387998","pcpadd":"720 Harrison Ave","pcpcity":"Boston","pcpstate":"MA","pcpzip":"02118","pcpcounty":"","pcpid":"","pcpname":"Evans Medical Foundation, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"B","add3":"","madd1":"50 San Juan St","madd2":"B","madd3":"","mcity":"Boston","mstate":"MA","mzip":"02118","pcpfaxno":"","pcpnpi":"1568449064","currentgendcomment":"","pphycomment":"","uniqueid":"160169300","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","N3281","E1165","K921","I429","R053","I428","I110","I447","E1142","E785","N401","Z87891","Z800","Z79899","Z7984","J069","E611","Z8711","Z7985","I5020","Z111","R42","R0789","I5023","R509","R0989","R9431","R000","I5021","I454","I5189","I700","J9811","N281","K5730","M51369"],"date":["2026-05-27","2026-02-03","2026-05-07","2026-05-07","2026-05-07","2026-05-07","2026-05-01","2026-04-29","2026-05-01","2026-04-26","2026-04-26","2026-04-26","2026-04-26","2026-04-26","2026-04-26","2026-04-26","2026-04-30","2026-04-26","2026-04-26","2026-04-26","2026-04-30","2026-05-11","2026-04-27","2026-04-27","2026-04-26","2026-04-27","2026-04-27","2026-04-27","2026-04-27","2026-05-01","2026-05-01","2026-04-25","2026-04-24","2026-04-24","2026-04-24","2026-04-24","2026-04-24"],"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":[["","","LISINOPRIL","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ASPIRIN EC","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","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":""}]}]}