{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Maksim Caushi","gend":0,"currentgend":"","add":"297 MAIN ST","city":"MEDFORD","state":"MA","zip":"02155","dob":"1969-03-20","age":"","mstatus":"","insh":"C0025516300","cliId":"","pno":7818662527,"cno":"","email":"","ename":"","eno":"","pphy":"Melissa Rowe","ppno":7813066101,"pcpadd":"170 Governors Ave,","pcpcity":"Medford","pcpstate":"MA","pcpzip":"02155","pcpcounty":"","pcpid":"","pcpname":"Hallmark Health Medical Associates","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"APT 11","add3":"","madd1":"297 MAIN ST","madd2":"APT 11","madd3":"","mcity":"MEDFORD","mstate":"MA","mzip":"02155","pcpfaxno":"","pcpnpi":1205282563,"currentgendcomment":"","pphycomment":"","uniqueid":109098850,"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":["M5459","M5417","M5416","M5116","M4726","M4727","M4317","R937","H0102B","H0102A","H40033","H5203","M2391","M25561","M23321","M23341","M25461","M23221","M23241","M65861","M2419","S83231D","S83271D","M79661","M25661","S8391XA","J4520","Z0000","Z1331","Z1339","Z130","Z131","Z125","Z13220","Z1211","L309","R220","R99","R351","H52223","H524","H53043"],"date":["2024-12-09","2024-12-22","2025-04-08","2024-12-22","2024-12-22","2024-12-22","2024-12-22","2025-03-17","2025-06-05","2025-06-05","2025-06-05","2025-06-05","2025-11-13","2025-08-04","2025-08-14","2025-08-14","2025-08-14","2025-08-14","2025-08-14","2025-08-14","2025-08-14","2025-11-13","2025-11-13","2025-11-11","2025-11-11","2025-08-04","2025-11-26","2025-11-26","2025-11-26","2025-11-26","2025-11-26","2025-11-26","2025-11-26","2025-11-26","2026-01-05","2025-12-30","2025-12-30","2025-08-04","2024-06-18","2024-09-25","2024-09-25","2024-09-25"],"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":[["","","LIDOCAINE","","","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":""}]}]}