{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Charles Wyatt","gend":0,"currentgend":"","add":"428 MAIN ST","city":"WEST DENNIS","state":"MA","zip":"02670","dob":"1965-11-22","age":"","mstatus":"","insh":"C0032191900","cliId":"","pno":7576477886,"cno":"","email":"","ename":"","eno":"","pphy":"Barbara K Prazak","ppno":5083493131,"pcpadd":"3130 State Hwy Rte 6,","pcpcity":"Wellfleet","pcpstate":"MA","pcpzip":"02667","pcpcounty":"","pcpid":"","pcpname":"Outer Cape Health Services","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"APT 25","add3":"","madd1":"428 MAIN ST","madd2":"APT 25","madd3":"","mcity":"WEST DENNIS","mstate":"MA","mzip":"02670","pcpfaxno":"","pcpnpi":1720190499,"currentgendcomment":"","pphycomment":"","uniqueid":142900050,"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":["R55","S0990XA","S0083XA","M542","S60051A","R404","I77810","R079","M19042","M79641","M25512","I252","R9431","R4182","I10","Z7901","Z7982","Z87891","W1839XA","Y9289","Y9389","M47812","M4802","R200","I2510","I255","I77811","I951","R42","M62838","E041","J358","F411","F331","Z789","G4733","E663","J343","J352","R09A2","J341","F332","Z23","F1190","I6502","R202","S098XXA","R262","R2689","G709","E782","F419","F32A","K219","I7140","Z7902","Z955","R7989","U099","Z13220","Z1159","Z114","M5450","Z7689","H25013","F5101","R0683","R0681","M1A49X0","R4189","R431","E785","R718","M79632","T148XXA","M79631","G4730","E669","H35373","H43812","H59811","H04123","E538","M47816","M7711","M7712","I213","I259","I517","I340","I358","I361","I371","I7121","M5412","M79604","M79605","I2119","E66812","Z6835","I5189","Z125","Z0000","Z1211","L03818","H26492","M48061","M9973","M5127","L720","M9971","M5023","M4312","I2111","N281","I7143","R937","M4722","G8929","R002","G464","Z79899","R9089","K635","K640","R99","R0602","R110","E11649","Z95818","Z7985"],"date":["2026-02-09","2025-11-13","2025-11-13","2026-02-09","2025-11-13","2025-11-13","2026-02-04","2025-11-10","2025-11-10","2025-11-10","2025-11-10","2026-02-04","2025-11-10","2025-11-10","2025-11-10","2025-11-10","2025-11-10","2025-11-10","2025-11-10","2025-11-10","2025-11-10","2026-01-12","2025-11-24","2025-11-24","2026-02-04","2026-02-04","2026-02-04","2025-12-04","2026-02-04","2026-01-12","2026-02-09","2025-11-19","2026-02-09","2026-01-12","2025-12-18","2026-02-09","2026-02-09","2025-12-30","2025-12-30","2025-12-30","2025-12-30","2026-02-12","2026-01-12","2026-01-12","2026-01-12","2026-01-29","2025-11-13","2025-11-13","2025-11-13","2025-11-10","2025-11-10","2025-11-10","2025-11-10","2025-12-11","2025-11-10","2025-11-10","2025-11-10","2024-07-31","2025-04-24","2024-07-31","2024-07-31","2024-07-31","2025-06-24","2024-07-31","2024-07-31","2026-02-03","2024-07-31","2024-07-31","2026-01-13","2025-09-18","2024-08-09","2025-09-05","2024-09-06","2025-09-18","2025-09-18","2025-09-18","2024-09-06","2025-12-03","2024-09-25","2024-09-25","2024-09-25","2024-09-25","2025-04-03","2025-08-07","2024-10-08","2024-10-08","2024-11-27","2024-11-22","2024-11-23","2024-11-23","2024-11-23","2025-02-04","2025-02-04","2024-11-23","2024-11-27","2024-11-27","2024-11-27","2025-02-04","2025-05-05","2025-01-27","2025-02-04","2025-02-07","2025-02-07","2025-10-10","2025-03-21","2025-04-01","2025-04-29","2025-04-29","2025-04-29","2025-05-15","2025-05-15","2025-05-15","2025-05-15","2025-07-11","2025-06-18","2025-07-07","2025-05-23","2025-06-24","2025-06-24","2025-09-05","2025-09-05","2025-09-03","2025-09-18","2025-10-10","2025-10-10","2026-02-26","2025-09-05","2025-09-05","2025-09-05","2025-09-05","2025-09-05"],"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":[["","","TRAZODONE HCL","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","WEGOVY","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","ASPIRIN EC","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","FREESTYLE LITE TEST STRIP","","","Select","Select",""],["","","FREESTYLE LANCETS","","","Select","Select",""],["","","PEG-3350 AND ELECTROLYTES","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","OLANZAPINE","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","ZEPBOUND","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}