{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Martha Fleury","gend":1,"currentgend":"","add":"37A LISBON ST","city":"MALDEN","state":"MA","zip":"02148","dob":"1963-02-10","age":"","mstatus":"","insh":"C0005656900","cliId":"","pno":7815395421,"cno":"","email":"","ename":"","eno":"","pphy":"Judith P Lytle","ppno":6174146800,"pcpadd":"930 Commonwealth Ave,","pcpcity":"Boston","pcpstate":"MA","pcpzip":"02215","pcpcounty":"","pcpid":"","pcpname":"Boston University Family Medicine,Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"37A LISBON ST","madd2":"","madd3":"","mcity":"MALDEN","mstate":"MA","mzip":"02148","pcpfaxno":"","pcpnpi":1437106226,"currentgendcomment":"","pphycomment":"","uniqueid":65623650,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["Creoles & Pidgin (FRE)"]],"comment":[[]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B351","I10","R99","M21619","B353","M79672","M25561","G8929","M79601","M25512","M79602","M546","Z1231","I2510","E785","E66811","Z6832","M5412","R7303","Z79899","Z0000","Z0001","D860","I421","R7989","N950","Z8619","Z227","M25562","Z1331","M170","R079","I77810","M79671","E782","E559"],"date":["2025-04-14","2025-11-12","2025-10-10","2024-04-04","2025-04-14","2024-02-26","2025-12-11","2025-09-16","2024-04-04","2025-05-07","2025-05-07","2025-05-07","2025-07-16","2025-09-16","2025-07-16","2025-07-16","2025-07-16","2025-11-08","2025-09-16","2025-07-16","2025-09-16","2025-09-16","2025-09-16","2025-09-16","2025-09-16","2025-09-16","2025-09-16","2025-09-16","2025-12-11","2025-03-10","2025-12-11","2025-05-07","2025-05-07","2025-07-16","2025-07-16","2025-07-16"],"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":[["","","KETOCONAZOLE","","","Select","Select",""],["","","TERBINAFINE HCL","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","METFORMIN HCL ER","","","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":""}]}]}