{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Idalia Castellanos","gend":1,"currentgend":"","add":"60 N MAIN ST","city":"NATICK","state":"MA","zip":"01760","dob":"1964-08-12","age":"","mstatus":"","insh":"C0042906400","cliId":"","pno":"5082508245","cno":"","email":"","ename":"","eno":"","pphy":"Ekaterina  Petersen","ppno":"6174142500","pcpadd":"11 Nevins St, Ste 505","pcpcity":"Brighton","pcpstate":"MA","pcpzip":"02135","pcpcounty":"","pcpid":"","pcpname":"Boston University Affiliated Physicians,Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 2","region":"","aligned":"","ano":"","add2":"APT 202","add3":"","madd1":"60 N MAIN ST","madd2":"APT 202","madd3":"","mcity":"NATICK","mstate":"MA","mzip":"01760","pcpfaxno":"","pcpnpi":"1972489227","currentgendcomment":"","pphycomment":"","uniqueid":"160208000","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":["N179","E43","E871","N280","I4719","K838","I10","E7800","R203","E869","R339","E876","R0902","L259","G8929","K219","K2950","F1290","Z905","Z87440","Z87442","Z9049","Z6827","Z0000","R17","G4489","R7989","R519","R109","J986","J9811","R1013","R002","R079","R42","M7062","M25552","M47817","M4187","R1110","K31A19","R112","R945","R1011","K2920","R1084","Z0001","Z59869","Z1331","Z1339","R630","Z5989","E2839","M8580","N6311","Z8041","Z833","H40013","I4710","E663","Z6829","R99","E039"],"date":["2026-03-10","2026-03-05","2026-03-05","2026-03-05","2026-03-10","2026-03-05","2026-04-08","2026-03-05","2026-03-05","2026-03-05","2026-03-06","2026-03-05","2026-03-05","2026-03-05","2026-03-17","2026-03-05","2026-03-09","2026-03-05","2026-03-05","2026-03-05","2026-03-05","2026-03-05","2026-03-05","2026-04-16","2026-04-16","2026-03-06","2026-03-17","2026-03-17","2026-03-10","2026-03-08","2026-03-08","2026-03-04","2026-03-04","2026-03-03","2026-03-03","2026-03-03","2026-03-09","2026-03-09","2026-03-09","2026-03-06","2026-03-09","2026-03-09","2026-03-06","2026-03-06","2026-03-09","2026-03-09","2026-03-17","2026-03-17","2026-03-17","2026-03-17","2026-03-17","2026-03-17","2026-03-17","2026-03-17","2026-03-17","2026-03-17","2026-03-17","2026-03-26","2026-04-08","2026-04-08","2026-04-08","2026-04-10","2026-03-04"],"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":[["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","BUTALBITAL-ACETAMINOPHEN-CAFFE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","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":""}]}]}