{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Marie E Demarco","gend":1,"currentgend":"","add":"860 BROAD ST","city":"EAST WEYMOUTH","state":"MA","zip":"02189","dob":"1979-01-23","age":"","mstatus":"","insh":"C0016039200","cliId":"","pno":7816547468,"cno":"","email":"","ename":"","eno":"","pphy":"Richard M Lubens","ppno":6172823200,"pcpadd":"398 Neponset Ave,","pcpcity":"Dorchester","pcpstate":"MA","pcpzip":"02122","pcpcounty":"","pcpid":"","pcpname":"Daniel Driscoll-Neponset Health Center","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"APT C","add3":"","madd1":"860 BROAD ST","madd2":"APT C","madd3":"","mcity":"EAST WEYMOUTH","mstate":"MA","mzip":"02189","pcpfaxno":"","pcpnpi":1730174392,"currentgendcomment":"","pphycomment":"","uniqueid":90019700,"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":["F339","F411","R45851","J45909","Z79899","F17290","Z1152","R451","R079","M549","F419","M25462","Z791","Z885","M25562","F410","F331","F4312","F332","F4310","F1190","K5909","R110","K429","R0602","Z5181","Z599","F4001","K2900","E876","K5900","R1084","Z20822","Z30432","Z139","M546","R202","R600","R509","M25561","G8929","Z0000","R99","F329","G43909","R200","R109","Z975","F1120","F32A","F1990","M1712","M79605","R609","G589","M25512","M25571","M7661","E66813","Z6841","H6592","H6690","L309","I10","E6601"],"date":["2024-03-20","2025-11-25","2024-02-18","2024-03-02","2024-08-15","2024-03-02","2024-02-17","2024-02-17","2024-03-20","2024-03-20","2024-11-06","2025-08-07","2024-01-08","2024-03-02","2024-08-19","2024-12-26","2025-11-25","2024-02-26","2025-11-03","2025-03-18","2024-12-09","2024-03-02","2024-11-02","2024-10-02","2024-02-14","2024-08-15","2024-02-14","2024-04-04","2024-10-02","2024-10-02","2024-11-02","2024-10-02","2024-02-14","2024-08-03","2024-06-03","2024-03-20","2024-03-20","2024-05-14","2024-05-31","2024-05-31","2024-05-31","2024-11-06","2025-12-24","2024-02-17","2024-02-18","2024-12-24","2024-11-02","2024-11-02","2025-11-21","2024-02-18","2024-02-18","2024-08-26","2024-01-08","2024-01-08","2024-12-24","2024-12-17","2025-02-09","2025-12-09","2025-09-16","2025-09-16","2025-01-13","2025-11-03","2025-08-07","2025-01-07","2025-06-05"],"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":[["","","BUPRENORPHINE-NALOXONE","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","CITALOPRAM HBR","","","Select","Select",""],["","","ASPIRIN","","","Select","Select",""],["","","ZOLMITRIPTAN ODT","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-HC","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","NAPROXEN","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","PHENTERMINE HCL","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","PREDNISONE","","","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":""}]}]}