{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"John W Lydon","gend":0,"currentgend":"","add":"71 COLBY DR","city":"HALIFAX","state":"MA","zip":"02338","dob":"1962-07-28","age":"","mstatus":"","insh":"C0012408901","cliId":"","pno":7812947161,"cno":"","email":"","ename":"","eno":"","pphy":"Nadalee M Angelos","ppno":7812933838,"pcpadd":"1 Donald's Way,Suite 200","pcpcity":"East Bridgewater","pcpstate":"MA","pcpzip":"02333","pcpcounty":"","pcpid":"","pcpname":"Signature Healthcare Medical Group, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"71 COLBY DR","madd2":"","madd3":"","mcity":"HALIFAX","mstate":"MA","mzip":"02338","pcpfaxno":"","pcpnpi":1790078863,"currentgendcomment":"","pphycomment":"","uniqueid":79270951,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R99","M5416","M79672","M79671","R200","M5126","M47816","M79604","Z0000","G5793","E119","M79676","E785","E1141","M79674","M79675","Z7984","G6289","R0781","Z1211","Z538","I10","E7800","D122","D128","K5730","K640","M7581","M7918","R1032","M1712","M48061","I428","I119","R7989","E559","Z125","E669","J302","Z6833","M47817","M4807","M4316","M5137","K5732","Z8719","G8929","I4510","M19011","Z98890","Z8249","Z9109","R9431","I452","L908","M25522","Z59861"],"date":["2025-12-25","2025-09-16","2024-08-22","2024-08-22","2024-10-10","2024-10-10","2025-05-21","2024-10-10","2025-05-22","2025-11-11","2024-11-19","2024-11-19","2025-11-11","2024-11-19","2024-11-19","2024-11-19","2024-11-19","2024-02-12","2024-12-26","2025-01-30","2025-01-29","2025-01-30","2025-01-30","2025-01-30","2025-01-30","2025-01-30","2025-01-30","2025-03-03","2025-04-15","2025-08-14","2024-07-02","2024-07-02","2025-05-27","2025-05-27","2024-05-22","2024-05-22","2024-05-22","2024-08-13","2024-05-28","2024-08-13","2024-09-23","2024-09-23","2024-09-23","2024-09-23","2025-02-01","2025-01-30","2025-01-14","2025-01-29","2025-03-03","2025-11-11","2025-11-11","2025-05-27","2025-05-27","2025-05-27","2025-11-11","2025-11-11","2025-11-11"],"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":[["","","IBUPROFEN","","","Select","Select",""],["","","REPATHA SURECLICK","","","Select","Select",""],["","","LOSARTAN-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","PEG 3350-ELECTROLYTE","","","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":""}]}]}