{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Alannah Larson","gend":1,"currentgend":"","add":"5 WEYMOUTH ST","city":"FITCHBURG","state":"MA","zip":"01420","dob":"1990-09-27","age":"","mstatus":"","insh":"C0026930000","cliId":"","pno":9788552351,"cno":"","email":"","ename":"","eno":"","pphy":"Garo H Garabedian","ppno":9788788100,"pcpadd":"326 Nichols Rd,","pcpcity":"Fitchburg","pcpstate":"MA","pcpzip":"01420","pcpcounty":"","pcpid":"","pcpname":"Community Health Connections, Inc","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"APT 1","add3":"","madd1":"5 WEYMOUTH ST","madd2":"APT 1","madd3":"","mcity":"FITCHBURG","mstate":"MA","mzip":"01420","pcpfaxno":"","pcpnpi":1962890038,"currentgendcomment":"","pphycomment":"","uniqueid":113271400,"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":["Z0189","Z6841","J4540","Z0000","Z8742","Z87891","Z130","Z139","E559","Z6839","Z1389","D229","R99","Z1151","Z124","Z113","Z118","L989","F339","F410","F411","F4310","N921","Z01419","R051","R0602","R0989","R052","R062","R053","J029","M7910"],"date":["2025-12-01","2025-02-24","2025-02-24","2025-12-01","2025-02-24","2025-02-24","2025-12-01","2025-12-01","2025-12-01","2025-12-01","2025-12-01","2025-12-01","2026-02-20","2024-06-18","2024-06-18","2024-06-18","2024-06-18","2026-01-14","2025-12-08","2025-12-08","2025-12-29","2025-12-08","2024-05-01","2024-06-18","2024-09-17","2024-09-17","2024-09-17","2025-01-04","2025-01-04","2024-10-23","2024-12-02","2024-12-02"],"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":[["","","ETONOGESTREL-ETHINYL ESTRADIOL","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","FLUTICASONE PROPIONATE HFA","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","IBUPROFEN","","","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":""}]}]}