{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Rhonda Ferrara","gend":1,"currentgend":"","add":"43 WENONAH RD","city":"BUZZARDS BAY","state":"MA","zip":"02532","dob":"1968-09-30","age":"","mstatus":"","insh":"C0015559900","cliId":"","pno":5082879750,"cno":"","email":"","ename":"","eno":"","pphy":"Marcia L Franklin","ppno":7745523212,"pcpadd":"1 Trowbridge Rd,Suite 100","pcpcity":"Bourne","pcpstate":"MA","pcpzip":"02532","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":"43 WENONAH RD","madd2":"","madd3":"","mcity":"BUZZARDS BAY","mstate":"MA","mzip":"02532","pcpfaxno":"","pcpnpi":1649227588,"currentgendcomment":"","pphycomment":"","uniqueid":89180850,"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":["M041","R99","M25512","S46011A","M25511","S46012A","N390","B9689","N3000","Z859","J328","N959","R051","H2513","Z01419","Z98890","Z1272","Z1151","R911","C49A3","M6520","A499","Z5321","F3181","J0100","R0981","Z0000","J341","J329","J342","Z124","Z90710","F17210","H52223","J3489","C49A0","K429","M419","Q438","J984","J939","I2510","H40011","J0110","J22","H25043","Z1239","Z1211","F418","B070","H2512","Z01818","H25013","H2511","J0101","Z87891"],"date":["2025-12-02","2025-12-16","2025-06-11","2025-06-11","2025-06-11","2025-06-11","2025-11-30","2025-11-30","2025-12-15","2025-12-15","2025-11-02","2024-08-26","2025-07-02","2025-09-07","2025-11-24","2025-07-02","2024-09-10","2024-09-10","2024-11-21","2025-03-19","2025-06-10","2025-11-30","2025-12-10","2025-11-09","2024-10-03","2024-10-03","2025-03-19","2024-06-26","2024-06-26","2024-06-26","2025-03-19","2024-09-10","2024-09-10","2024-10-22","2024-03-21","2024-11-21","2024-11-21","2024-11-21","2024-11-21","2024-11-21","2024-11-21","2024-11-21","2024-11-12","2025-01-23","2025-01-23","2025-11-02","2025-03-19","2025-03-19","2025-09-07","2025-10-06","2025-07-15","2025-09-07","2025-09-07","2025-07-21","2025-08-09","2025-08-09"],"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":[["","","AZELASTINE HCL","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","LAMOTRIGINE","","","Select","Select",""],["","","PROGESTERONE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","TOBRAMYCIN","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","CEFUROXIME","","","Select","Select",""],["","","CEFDINIR","","","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":""}]}]}