{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sara J Lambert","gend":1,"currentgend":"","add":"1585 BRALEY RD","city":"NEW BEDFORD","state":"MA","zip":"02745","dob":"1980-08-11","age":"","mstatus":"","insh":"C0019828100","cliId":"","pno":7743016749,"cno":"","email":"","ename":"","eno":"","pphy":"Shobi Sundar","ppno":5087303000,"pcpadd":"1030 President Ave,Ste 1001","pcpcity":"Fall River","pcpstate":"MA","pcpzip":"02720","pcpcounty":"","pcpid":"","pcpname":"Southcoast Physicians Group, Inc","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"APT 57","add3":"","madd1":"1585 BRALEY RD","madd2":"APT 57","madd3":"","mcity":"NEW BEDFORD","mstate":"MA","mzip":"02745","pcpfaxno":"","pcpnpi":1467454611,"currentgendcomment":"","pphycomment":"","uniqueid":98312350,"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","M546","J40","R0989","J989","E66812","F902","E611","N920","Z809","Z90710","D509","G43019","Z202","E6601","F909","R300","Z6837","R0602","J329","J040","Z1152","E559","T7840XS","R7303","F4310","F502","F900","F4312","F3181","F332","F3342","S298XXA","S299XXA","R0789","M419","Z0000","E348","F50819","Z9884","K5909","Z91048","D508","Z23","R051","R059","J320","J029","R058","M50322","J0190","J0101","H00025","H00021","H01001","H01004","F908","R768","Z6838","E282","G43009","Z833","Z8249","Z818","Z1211"],"date":["2025-12-26","2024-09-18","2024-10-20","2024-10-24","2025-09-17","2025-12-30","2025-12-17","2024-01-02","2024-01-02","2025-04-11","2024-01-02","2024-07-02","2025-09-17","2024-01-10","2024-01-10","2025-06-10","2024-01-10","2025-04-11","2024-10-29","2024-10-29","2024-10-29","2024-10-29","2025-09-17","2025-09-17","2025-09-17","2025-12-08","2024-12-03","2025-12-08","2025-10-14","2025-10-02","2025-10-14","2025-07-15","2024-09-18","2024-09-18","2024-09-18","2024-09-18","2025-06-10","2025-09-17","2025-09-17","2025-09-17","2025-09-17","2025-06-10","2025-09-17","2025-06-10","2024-10-20","2024-10-20","2024-10-29","2024-10-29","2024-10-29","2024-10-29","2024-10-28","2024-11-18","2025-06-03","2025-05-28","2025-05-28","2025-05-28","2025-09-17","2025-09-17","2025-06-10","2025-06-10","2025-06-10","2025-04-11","2025-04-11","2025-04-11","2025-04-11"],"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":[["","","VENLAFAXINE HCL ER","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","DEXTROAMPHETAMINE-AMPHETAMINE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","REXULTI","","","Select","Select",""],["","","BACLOFEN","","","Select","Select",""],["","","LIDOCAINE","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","BENZONATATE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","BUDESONIDE","","","Select","Select",""],["","","IPRATROPIUM-ALBUTEROL","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","ZEPBOUND","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","VRAYLAR","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","PRIORIX","","","Select","Select",""],["","","BOOSTRIX TDAP","","","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":""}]}]}