{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ryan Greaney","gend":0,"currentgend":"","add":"57 CIRCUIT RD N","city":"WEST YARMOUTH","state":"MA","zip":"02673","dob":"1981-01-16","age":"","mstatus":"","insh":"C0003652900","cliId":"","pno":5085660800,"cno":"","email":"","ename":"","eno":"","pphy":"Mark E Collins","ppno":5084282620,"pcpadd":"10 Osterville West Barnstable Rd,","pcpcity":"Osterville","pcpstate":"MA","pcpzip":"02655","pcpcounty":"","pcpid":"","pcpname":"Cape Cod Primary Care LLC","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"36 CAMMETT LN","madd2":"","madd3":"","mcity":"MARSTONS MLS","mstate":"MA","mzip":"02648","pcpfaxno":"","pcpnpi":1255368494,"currentgendcomment":"","pphycomment":"","uniqueid":61305550,"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":["A419","L700","G8929","M726","F17200","R21","Z79899","L03315","G35","Z880","Z87892","N492","F17210","F909","F419","M7989","Z5189","F332","M9901","M5412","M9902","M546","M9903","M9905","F900","R059","R062","J209","R509","R935","R000","R9431","M7910","A429","R52","K219","N528","G35D","G35A","D72810","R799","R945","Z0000","Z0184","Z1159","R99"],"date":["2024-05-17","2024-05-17","2024-05-17","2024-07-06","2024-07-05","2024-05-17","2024-05-18","2024-05-18","2025-07-16","2024-05-18","2024-05-18","2024-05-18","2024-12-05","2024-05-18","2024-05-21","2024-11-06","2024-11-06","2025-11-20","2024-03-05","2024-07-19","2024-03-05","2024-03-05","2024-01-05","2024-01-05","2024-11-04","2024-12-05","2024-12-05","2024-12-05","2024-12-05","2024-05-17","2024-05-17","2024-05-17","2024-05-17","2024-05-21","2024-05-17","2025-07-11","2025-07-11","2025-11-18","2025-11-18","2025-11-18","2025-11-18","2025-11-18","2025-11-18","2025-11-18","2025-11-18","2025-12-30"],"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":[["","","DEXTROAMPHETAMINE-AMPHETAMINE","","","Select","Select",""],["","","CLINDAMYCIN PHOSPHATE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","CICLOPIROX","","","Select","Select",""],["","","BACLOFEN","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","HYDROXYZINE PAMOATE","","","Select","Select",""],["","","OMEPRAZOLE","","","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":""}]}]}