{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Wenflore K Mirbel","gend":1,"currentgend":"","add":"140 KENNEDY DR","city":"MALDEN","state":"MA","zip":"02148","dob":"1974-12-28","age":"","mstatus":"","insh":"C0012786900","cliId":"","pno":3474589440,"cno":"","email":"","ename":"","eno":"","pphy":"Sarah R Gottfried","ppno":7814858222,"pcpadd":"454 Broadway,","pcpcity":"Revere","pcpstate":"MA","pcpzip":"02151","pcpcounty":"","pcpid":"","pcpname":"Cambridge Public Health Commission","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"APT 1","add3":"","madd1":"140 KENNEDY DR","madd2":"APT 1","madd3":"","mcity":"MALDEN","mstate":"MA","mzip":"02148","pcpfaxno":"","pcpnpi":1629393418,"currentgendcomment":"","pphycomment":"","uniqueid":79749550,"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":["J029","R300","E119","Z794","N939","R102","G8929","D251","D252","N8003","Z30431","N6489","J069","I10","R202","E113293","M79671","M79672","Z8639","R200","R928","N644","D3502","E1165","E785","E249","Z1211","Z1212","L918","H5203","H52203","H524","H25813","Z30430","Z0000","Z9189","R42","M549","R99","N760","E2609"],"date":["2025-02-13","2025-02-13","2025-10-22","2025-10-22","2025-09-04","2025-09-04","2025-09-04","2025-09-04","2025-09-04","2025-09-04","2025-09-04","2025-05-27","2025-09-16","2025-08-10","2025-10-22","2025-10-13","2025-10-18","2025-10-18","2025-10-13","2025-10-22","2025-02-12","2024-06-03","2024-08-03","2025-05-06","2024-03-27","2024-03-27","2024-09-09","2024-09-09","2024-10-25","2024-10-25","2024-10-25","2024-10-25","2024-10-25","2024-11-21","2024-10-25","2024-12-12","2024-12-18","2025-02-13","2025-12-30","2024-10-23","2024-02-22"],"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":[["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","FREESTYLE LIBRE 2 SENSOR","","","Select","Select",""],["","","CHLORTHALIDONE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","FREESTYLE LIBRE 2 PLUS SENSOR","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","VITAMIN D2","","","Select","Select",""],["","","TRUEPLUS LANCETS","","","Select","Select",""],["","","FREESTYLE LITE TEST STRIP","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","UNIFINE PENTIPS","","","Select","Select",""],["","","LANTUS","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","NORTRIPTYLINE HCL","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","NORETHINDRONE ACETATE","","","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":""}]}]}