{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ilham El Aaoud","gend":1,"currentgend":"","add":"103 ENDICOTT AVE","city":"REVERE","state":"MA","zip":"02151","dob":"1988-08-29","age":"","mstatus":"","insh":"C0005979000","cliId":"","pno":7814847222,"cno":"","email":"","ename":"","eno":"","pphy":"Priya Sapra","ppno":6175695800,"pcpadd":"10 Gove St,","pcpcity":"East Boston","pcpstate":"MA","pcpzip":"02128","pcpcounty":"","pcpid":"","pcpname":"NeighborHealth Corporation","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"APT 3","add3":"","madd1":"103 ENDICOTT AVE","madd2":"APT 3","madd3":"","mcity":"REVERE","mstate":"MA","mzip":"02151","pcpfaxno":"","pcpnpi":1184076515,"currentgendcomment":"","pphycomment":"","uniqueid":65891150,"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","M5030","Z30011","O26843","O99213","O09523","Z6838","Z3490","O3660X0","K6030","R197","R000","O9962","O34593","O99824","O6981X0","O3663X0","O9902","D649","O99892","O9089","R339","O872","Z3A39","Z370","Z881","Z888","Z8616","Z833","K610","E669","Z6836","O0990","O2340","B951","O76","O99013","O99820","O43893","R1030","K612","M50123","Z6837","K611","Z392"],"date":["2025-08-20","2025-03-19","2025-04-14","2025-06-02","2025-06-02","2025-06-02","2025-06-02","2025-06-02","2025-06-02","2025-09-29","2025-02-19","2025-02-19","2025-02-28","2025-02-28","2025-02-28","2025-02-28","2025-02-28","2025-02-28","2025-02-28","2025-02-28","2025-02-28","2025-02-28","2025-02-28","2025-03-02","2025-02-28","2025-02-28","2025-02-28","2025-02-28","2025-02-28","2025-04-28","2025-08-20","2025-08-20","2025-02-17","2025-02-17","2025-02-17","2025-02-28","2025-03-02","2025-03-02","2025-05-03","2025-02-03","2025-07-02","2025-03-19","2025-03-19","2025-02-28","2025-04-14"],"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":[["","","IBUPROFEN","","","Select","Select",""],["","","ENOXAPARIN SODIUM","","","Select","Select",""],["","","LIDOCAINE","","","Select","Select",""],["","","SLYND","","","Select","Select",""],["","","OXYCODONE 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":""}]}]}