{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Shawn Murphy","gend":0,"currentgend":"","add":"57 GROVE ST","city":"FAIRHAVEN","state":"MA","zip":"02719","dob":"1965-01-15","age":"","mstatus":"","insh":"C0006079500","cliId":"","pno":5088639044,"cno":"","email":"","ename":"","eno":"","pphy":"Abena A Addo","ppno":5089961800,"pcpadd":"208 Mill Rd,","pcpcity":"Fairhaven","pcpstate":"MA","pcpzip":"02719","pcpcounty":"","pcpid":"","pcpname":"Southcoast Physicians Group, Inc","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"57 GROVE ST","madd2":"","madd3":"","mcity":"FAIRHAVEN","mstate":"MA","mzip":"02719","pcpfaxno":"","pcpnpi":1366543225,"currentgendcomment":"","pphycomment":"","uniqueid":65957400,"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":["S52502D","M0609","M2550","Z5181","Z7960","F331","Z79899","M069","R918","R6883","R197","E807","R051","R112","R0981","R5383","R509","J0190","H6692","H6693","J0101","F338","H6993","H938X3","Z0000","Z23","Z122","F17210","F1091","F419","F32A","Z87891","Z716","J432","R0602","G4733","R12","F17200","E785","F1090","I2510","S5290XA","S6992XA","S52502A","Z01810","R9431","S52572A","S52612A","W19XXXA","M19031","S52572D","S52612D","S52612K","Z91199","G8918","R99","S52509A","R059","E806","K219","Z20822","J329","B9689","Z635","R252"],"date":["2026-01-29","2026-02-05","2026-02-05","2026-02-05","2026-02-05","2025-06-17","2025-01-31","2024-10-28","2025-11-18","2024-10-28","2024-10-28","2024-10-28","2024-10-28","2024-10-28","2024-10-28","2024-10-28","2024-11-10","2024-11-10","2024-11-10","2025-03-26","2025-03-26","2025-03-11","2024-12-17","2024-12-17","2025-01-31","2025-01-31","2025-03-21","2025-11-18","2025-01-31","2025-03-11","2025-06-16","2025-03-21","2025-09-15","2025-09-15","2025-05-21","2026-02-03","2025-04-28","2025-06-16","2025-06-16","2025-06-16","2025-09-02","2025-09-22","2025-09-22","2025-09-24","2025-09-25","2025-09-25","2025-09-25","2025-09-25","2025-09-25","2025-09-24","2025-09-22","2025-11-19","2025-10-08","2025-11-18","2025-09-25","2026-02-06","2025-09-22","2024-10-28","2024-10-28","2024-10-28","2024-10-28","2024-11-10","2024-11-10","2024-11-10","2025-09-22"],"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":[["","","ENBREL SURECLICK","","","Select","Select",""],["","","HYDROXYCHLOROQUINE SULFATE","","","Select","Select",""],["","","VARENICLINE TARTRATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","BENZONATATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUCELVAX TRIVALENT 2024-2025","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","NICOTINE PATCH","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","CIMZIA","","","Select","Select",""],["","","CIMZIA (2 PACK)","","","Select","Select",""],["","","NALOXONE HCL","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","MORPHINE SULFATE","","","Select","Select",""],["","","POLYETHYLENE GLYCOL 3350","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","FLUCELVAX 2025-2026","","","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":""}]}]}