{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Karianne Flaherty","gend":1,"currentgend":"","add":"302 FIELD ST","city":"BROCKTON","state":"MA","zip":"02302","dob":"2000-04-27","age":"","mstatus":"","insh":"C0032321900","cliId":"","pno":7744177478,"cno":"","email":"","ename":"","eno":"","pphy":"Nikita Fitzcharles","ppno":7819254550,"pcpadd":"180 George Washington Blvd,","pcpcity":"Hull","pcpstate":"MA","pcpzip":"02045","pcpcounty":"","pcpid":"","pcpname":"Manet Community Health Center, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"302 FIELD ST","madd2":"","madd3":"","mcity":"BROCKTON","mstate":"MA","mzip":"02302","pcpfaxno":"","pcpnpi":1356607584,"currentgendcomment":"","pphycomment":"","uniqueid":143113050,"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":["O26899","O99810","O365930","O09293","O34219","Z8759","Z3A28","O0993","Z3A29","O09299","O365910","O365990","O26893","R1010","Z3A30","O368130","Z3A31","Z3A32","O359XX0","Z3A34","Z3685","Z3A37","O80","Z3A39","Z3009","Z370","R768","Z01818","Z302","N838","R99","Z3682","Z360","Z3689","Z7982","Z87410","O283","O99891","R1013","R030","O368330","Z362","Z364","O43193","O34211","O770","O701","O7182","Z8679","Z392","I10","Z87891","J45909","O26891","R110","O3680X0","Z3491","Z3481","O09291","N83292","Z3A12","Z3402","O09292","Z3A19","Z131","Z6791","Z30430"],"date":["2025-03-25","2025-03-26","2025-06-12","2025-06-19","2025-06-24","2025-05-15","2025-03-28","2025-04-24","2025-04-10","2025-04-17","2025-05-22","2025-04-09","2025-04-16","2025-04-16","2025-04-17","2025-04-18","2025-04-24","2025-05-01","2025-05-15","2025-05-15","2025-05-27","2025-06-05","2025-06-24","2025-06-19","2025-06-30","2025-06-21","2025-06-19","2025-08-29","2025-09-02","2025-09-02","2025-09-02","2024-12-12","2024-12-12","2025-01-30","2025-05-15","2025-05-15","2025-04-17","2025-04-16","2025-04-16","2025-04-16","2025-04-18","2025-06-19","2025-05-08","2025-05-15","2025-06-19","2025-06-19","2025-06-19","2025-06-19","2025-06-19","2025-06-24","2025-09-02","2025-09-02","2025-09-02","2024-11-08","2024-11-08","2024-11-08","2024-11-12","2024-11-08","2024-12-12","2024-12-12","2024-12-12","2024-12-26","2025-01-30","2025-01-30","2025-03-13","2025-03-25","2025-03-25"],"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":[["","","AMOXICILLIN","","","Select","Select",""],["","","METOCLOPRAMIDE HCL","","","Select","Select",""],["","","PROMETHAZINE HCL","","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","","","Select","Select",""],["","","FAMOTIDINE","","","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":""}]}]}