{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Julie M Roos","gend":1,"currentgend":"","add":"2 PINE ST","city":"BERKLEY","state":"MA","zip":"02779","dob":"1967-07-15","age":"","mstatus":"","insh":"C0020829500","cliId":"","pno":5088239333,"cno":"","email":"","ename":"","eno":"","pphy":"Hannah R Stoops","ppno":5089731570,"pcpadd":"479 Swansea Mall Dr,","pcpcity":"Swansea","pcpstate":"MA","pcpzip":"02777","pcpcounty":"","pcpid":"","pcpname":"Southcoast Physicians Group, Inc","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"2 PINE ST","madd2":"","madd3":"","mcity":"BERKLEY","mstate":"MA","mzip":"02779","pcpfaxno":"","pcpnpi":1396265724,"currentgendcomment":"","pphycomment":"","uniqueid":99962100,"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":["I83893","R059","H02413","E1151","F17200","E66811","E785","Z6833","I10","E249","L989","E282","E7849","F40243","Z1283","I8390","I872","E119","G4733","E669","E6609","I83813","I723","M549","E278","N200","K429","Q600","L918","N952","Z1211","K635","D125","K621","Z6832","R7303","F17210","Z7984","Z7985","E1159","I739","R0789","R109","D259","Z880","E279","R300","M7910","M2550","T148XXA","E7800","H5213","H02411","H02412","M79604","M79605","N926","N83202","N939","N8300","N950","A630","N858","R079","K5641","I700","L700","L821","L814","L578","L720","L573","D2372","D2361","L738","E240","K760","I82813","E66812","E6601","R99","Z124"],"date":["2025-07-08","2025-05-27","2025-06-09","2025-06-26","2025-06-26","2025-12-31","2025-09-20","2025-08-12","2025-06-26","2025-11-21","2025-06-26","2025-12-22","2025-08-12","2025-06-26","2025-06-26","2025-07-08","2025-07-08","2025-08-12","2025-08-12","2025-08-12","2025-08-12","2025-09-23","2025-10-10","2025-10-10","2025-10-07","2025-10-07","2025-10-07","2025-10-07","2025-12-11","2025-12-11","2024-07-24","2024-07-24","2024-07-24","2024-07-24","2024-07-24","2024-09-12","2024-07-24","2024-07-24","2024-07-24","2024-11-07","2024-10-02","2024-09-12","2024-09-12","2024-10-02","2024-09-12","2025-01-06","2024-12-19","2025-08-11","2025-08-12","2025-08-12","2024-07-24","2024-04-15","2024-04-15","2024-04-15","2025-04-21","2025-04-21","2024-06-10","2024-06-10","2024-06-10","2024-06-10","2024-06-27","2024-06-27","2024-06-27","2024-09-12","2024-09-12","2024-10-02","2024-10-25","2024-10-25","2024-10-25","2024-10-25","2024-10-25","2024-10-25","2024-10-25","2024-10-25","2024-10-25","2025-03-03","2025-03-03","2024-11-21","2025-01-09","2025-01-09","2025-12-22","2024-06-27"],"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":[["","","CILOSTAZOL","","","Select","Select",""],["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","FREESTYLE LITE TEST STRIP","","","Select","Select",""],["","","FREESTYLE LANCETS","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","BENZONATATE","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","ZEPBOUND","","","Select","Select",""],["","","ESTRADIOL","","","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":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}