{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sheila V Mcelroy","gend":1,"currentgend":"","add":"17 SAFFORD ST","city":"HYDE PARK","state":"MA","zip":"02136","dob":"1970-11-23","age":"","mstatus":"","insh":"C0029518400","cliId":"","pno":6177502074,"cno":"","email":"","ename":"","eno":"","pphy":"Daniel J Sullivan","ppno":6176679600,"pcpadd":"330 Brookline Ave,","pcpcity":"Boston","pcpstate":"MA","pcpzip":"02215","pcpcounty":"","pcpid":"","pcpname":"Beth Israel DeaconessMedical Center","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"17 SAFFORD ST","madd2":"","madd3":"","mcity":"HYDE PARK","mstate":"MA","mzip":"02136","pcpfaxno":"","pcpnpi":1659460145,"currentgendcomment":"","pphycomment":"","uniqueid":138505100,"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":["Z0000","E039","I10","R7303","E66811","Z6832","M1611","Z130","R079","R9431","Z1231","J029","E611","E669","Z6833","Z23","L309","Z13220","L659","D508","J45909","M7989","Z0001","K219","L209","F909","H401130","R059","M179","H401133","H25093","R490","J383","J310","M25551","L2089","L308","L649","J45901","Z0389","R922","Z853","Z803","Z01818","M25851","M25751","H16001","H18821","Z973","Z471","Z96641","Z98890","H5213","N898","M25562","M25861","M23341","M25461","M11261","M25561","M2391","M1711","S83281D","N951","N949","M222X1","M1712","E876","H00011","L905","L03312","J4540","R99","L03011","D563","E890","Z90710","Z9089","Z4789","J309","Z7951","Z792","Z7982","Z79891"],"date":["2025-11-14","2025-12-18","2025-11-25","2025-11-14","2025-08-04","2025-08-04","2025-08-04","2025-08-22","2025-12-15","2025-12-15","2025-10-21","2025-10-27","2025-11-14","2025-11-14","2025-11-14","2025-11-14","2025-11-14","2025-11-14","2025-11-26","2026-01-12","2026-02-17","2025-08-22","2024-05-29","2024-12-10","2024-12-10","2024-12-10","2024-05-29","2024-05-29","2024-05-29","2026-02-05","2026-02-05","2024-07-26","2024-07-26","2024-07-05","2025-07-29","2024-07-15","2024-07-15","2024-07-15","2024-05-13","2024-05-13","2024-05-29","2024-05-29","2024-05-29","2024-12-23","2024-12-05","2024-12-05","2024-12-06","2024-12-06","2024-12-06","2025-07-29","2025-07-29","2024-12-12","2026-02-05","2025-02-21","2025-04-02","2025-04-02","2025-04-08","2025-04-08","2025-04-08","2025-04-02","2025-04-08","2025-07-29","2025-08-04","2025-08-04","2025-04-28","2025-07-29","2025-07-29","2025-08-22","2025-11-06","2025-11-26","2025-11-25","2024-05-29","2026-02-27","2024-07-03","2025-02-05","2024-12-10","2024-12-10","2024-12-10","2025-02-05","2025-02-05","2025-02-05","2025-02-05","2025-02-05","2025-02-05"],"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":[["","","BRIMONIDINE TARTRATE","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","NAPROXEN","","","Select","Select",""],["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","BETAMETHASONE DIPROPIONATE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ALBUTEROL SULFATE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","ASPIRIN EC","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","ESTRADIOL (ONCE WEEKLY)","","","Select","Select",""],["","","VALSARTAN","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","LATANOPROST","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","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":""}]}]}