{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Okwha Byun","gend":1,"currentgend":"","add":"448 NAHATAN ST","city":"NORWOOD","state":"MA","zip":"02062","dob":"1970-06-24","age":"","mstatus":"","insh":"C0016806001","cliId":"","pno":6179972435,"cno":"","email":"","ename":"","eno":"","pphy":"Linda C Tsai","ppno":7814533765,"pcpadd":"148 Chestnut St,","pcpcity":"Needham","pcpstate":"MA","pcpzip":"02492","pcpcounty":"","pcpid":"","pcpname":"Medical Care of Boston Management Corp.","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"448 NAHATAN ST","madd2":"","madd3":"","mcity":"NORWOOD","mstate":"MA","mzip":"02062","pcpfaxno":"","pcpnpi":1750489449,"currentgendcomment":"","pphycomment":"","uniqueid":91700201,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25511","F419","K219","R053","F40243","M7501","M7531","Z0000","R12","K2090","K2960","R1012","R109","Z1231","Z1211","K648","Z860100","Z79899","E785","F1090","M2550","E782","M7532","G4700","F1020","Z1331","Z0001","D72819","J029","Z20822","K3189","R197","Z23","L989","Z1339","R1084","K921","K625","L821","M25512","G8929","M19012"],"date":["2024-11-04","2025-10-14","2025-06-13","2024-08-22","2025-06-24","2024-11-04","2024-11-04","2025-02-05","2024-08-05","2024-08-05","2024-08-05","2025-11-02","2025-11-02","2025-05-15","2025-06-13","2025-06-13","2025-06-13","2025-06-13","2025-06-13","2025-06-13","2025-10-15","2025-10-15","2025-10-30","2024-03-26","2024-04-26","2025-02-05","2025-02-05","2025-10-14","2024-08-22","2024-08-22","2024-08-05","2025-04-02","2025-10-28","2025-02-05","2025-10-14","2025-05-29","2025-05-29","2025-06-13","2025-08-19","2025-10-14","2025-10-14","2025-10-30"],"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":[["","","DICLOFENAC SODIUM","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","BENZONATATE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","LORAZEPAM","","","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":""}]}]}