{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Demetrios m Kalkanis","gend":0,"currentgend":"","add":"52 TARA TER","city":"BUZZARDS BAY","state":"MA","zip":"02532","dob":"1973-02-13","age":"","mstatus":"","insh":"C0006813500","cliId":"","pno":5087892030,"cno":"","email":"","ename":"","eno":"","pphy":"Thomas A Hanna","ppno":5088338247,"pcpadd":"2 Jan Sebastian Dr,","pcpcity":"Sandwich","pcpstate":"MA","pcpzip":"02563","pcpcounty":"","pcpid":"","pcpname":"Medical Affiliates of Cape Cod, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"52 TARA TER","madd2":"","madd3":"","mcity":"BUZZARDS BAY","mstate":"MA","mzip":"02532","pcpfaxno":"","pcpnpi":1366418097,"currentgendcomment":"","pphycomment":"","uniqueid":66401000,"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":["B009","I10","M19049","R99","G894","F411","E669","M180","M159","E83110","K257","R1013","R1032","K921","K5730","K649","T84020A","E782","Z79899","Z7982","Z0000","Z23","M1812","M65842","Z96641","M1711","D649","R5382","N400","M109"],"date":["2025-12-18","2025-08-13","2025-10-05","2025-12-29","2025-05-21","2025-12-30","2025-12-15","2025-10-02","2025-10-02","2025-10-02","2025-10-28","2025-10-28","2025-10-28","2025-10-28","2025-10-28","2025-10-28","2025-11-14","2025-11-14","2025-11-14","2025-11-14","2025-01-31","2024-03-18","2024-05-13","2024-05-13","2025-01-30","2024-10-09","2025-01-31","2025-01-31","2025-01-31","2025-01-31"],"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":[["","","VALACYCLOVIR","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","HYDROXYCHLOROQUINE SULFATE","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","FINASTERIDE","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","ZEPBOUND","","","Select","Select",""],["","","FLUBLOK 2025-2026","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","SOD SULF-POTASS SULF-MAG SULF","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","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":""}]}]}