{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Nancy e Buckley","gend":1,"currentgend":"","add":"1 WEEKS POND DR","city":"FORESTDALE","state":"MA","zip":"02644","dob":"1973-06-04","age":"","mstatus":"","insh":"C0001076700","cliId":"","pno":5086330566,"cno":"","email":"","ename":"","eno":"","pphy":"Kristy K Brown","ppno":5084777090,"pcpadd":"107 Commercial St,","pcpcity":"Mashpee","pcpstate":"MA","pcpzip":"02649","pcpcounty":"","pcpid":"","pcpname":"Community Health Center of Cape Cod","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 1407","madd2":"","madd3":"","mcity":"SANDWICH","mstate":"MA","mzip":"02563","pcpfaxno":"","pcpnpi":1417939661,"currentgendcomment":"","pphycomment":"","uniqueid":56076400,"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":["L719","I10","R220","Z79899","R519","E119","H0589","F17200","Z973","M7989","G8929","Z87891","J320","J322","J329","R42","R609","E041","R590","M25561","Z1231","J0190","B9689","E559","E782","K760","J309","R110","J341","I517","J3489","H938X3","R448","H5310","H6593","I119","J342","J0100","H66002","J343","J321","J301","H6983","R0981","H938X9","H9319","K029","R002","R232","J349","M542","Z03821","R222","B370","B351","R202","G4451","H9313","J3089","Z0001","R635","R200","R21","G4452","L821","L814","D225","D2272","D2271","D2261","D2262","E66813","Z6843","R2241","M1711","Z0101","L659","U071","H9202","S80911A"],"date":["2025-02-27","2025-11-30","2024-10-22","2024-08-10","2025-01-15","2025-11-30","2024-10-21","2024-10-21","2024-10-21","2024-10-20","2024-10-22","2024-10-22","2024-11-15","2024-11-15","2025-03-24","2025-03-04","2024-11-25","2024-11-07","2025-02-19","2025-07-07","2024-02-29","2025-03-04","2024-12-08","2024-01-10","2025-11-20","2024-10-29","2024-01-07","2024-01-07","2024-08-28","2024-06-29","2025-10-01","2024-12-09","2024-12-09","2024-07-18","2024-12-08","2024-12-08","2024-08-28","2024-08-30","2024-08-30","2025-01-30","2024-09-26","2024-09-26","2024-09-26","2025-03-04","2024-09-24","2024-09-24","2024-09-27","2024-10-29","2024-11-20","2024-08-10","2024-08-10","2024-10-22","2024-10-20","2024-10-31","2024-10-31","2024-10-31","2024-11-20","2024-07-11","2025-03-24","2025-03-24","2025-03-24","2025-03-24","2025-03-24","2025-06-24","2025-02-27","2025-02-27","2025-02-27","2025-02-27","2025-02-27","2025-02-27","2025-02-27","2025-11-20","2025-11-20","2024-10-20","2025-10-30","2025-07-17","2025-11-20","2025-11-30","2025-11-30","2025-07-07"],"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":[["","","CARVEDILOL","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","CEFDINIR","","","Select","Select",""],["","","SUMATRIPTAN SUCCINATE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","INDOMETHACIN","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","INDOMETHACIN ER","","","Select","Select",""],["","","DIAZEPAM","","","Select","Select",""],["","","BUDESONIDE","","","Select","Select",""],["","","GLIMEPIRIDE","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","CIPRO HC","","","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":""}]}]}