{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jessica Parson","gend":1,"currentgend":"","add":"14 White Pine Avenue","city":"West Wareham","state":"MA","zip":"02576","dob":"1991-07-25","age":"","mstatus":"","insh":"C0038990700","cliId":"","pno":7748105134,"cno":"","email":"","ename":"","eno":"","pphy":"Adnan El-Amine","ppno":7815855518,"pcpadd":"11 Tremont St,","pcpcity":"Kingston","pcpstate":"MA","pcpzip":"02364","pcpcounty":"","pcpid":"","pcpname":"Kingsbury Primary Care","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"14 White Pine Avenue","madd2":"","madd3":"","mcity":"West Wareham","mstate":"MA","mzip":"02576","pcpfaxno":"","pcpnpi":1588722979,"currentgendcomment":"","pphycomment":"","uniqueid":153573700,"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":["R99","L821","L918","A630","D487","Z0000","R1020","M6289","G8929","R102","L501","J301","J3089","R059","F418","E559","L989","N630","Z8719","E663","N641","R92343","N6310","N83209","N946","K581","J989","N809","D225","L309","L700","N6315","N6489","K130","Z01411","N6320","Z1330","Z8709","R739","M797","N6311"],"date":["2026-02-15","2025-06-13","2025-06-13","2025-06-13","2025-06-13","2025-11-20","2025-12-29","2025-12-29","2025-12-29","2025-09-16","2025-12-02","2025-12-02","2025-12-02","2025-12-02","2025-09-25","2025-11-20","2025-07-18","2025-09-25","2025-07-18","2025-09-25","2025-10-07","2025-11-14","2025-09-02","2025-09-16","2025-11-14","2025-09-25","2025-09-25","2025-11-20","2025-10-03","2025-10-03","2025-11-05","2025-10-07","2025-10-07","2025-11-05","2025-11-14","2025-11-14","2025-11-20","2025-11-20","2025-11-20","2025-11-20","2026-01-06"],"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":[["","","NORETHINDRONE","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","PHENTERMINE HCL","","","Select","Select",""],["","","CLINDAMYCIN PHOSPHATE","","","Select","Select",""],["","","TRETINOIN","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","ADAPALENE-BENZOYL PEROXIDE","","","Select","Select",""],["","","EPINEPHRINE","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","ALPRAZOLAM","","","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":""}]}]}