{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael P Kane","gend":0,"currentgend":"","add":"17 HUCKLEBERRY LN","city":"MARSTONS MLS","state":"MA","zip":"02648","dob":"1980-01-12","age":"","mstatus":"","insh":"C0017924600","cliId":"","pno":6176486357,"cno":"","email":"","ename":"","eno":"","pphy":"Maysabel Aponte-Rivera","ppno":5082105965,"pcpadd":"3 Market Xing,Ste 2","pcpcity":"Plymouth","pcpstate":"MA","pcpzip":"02360","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":"17 HUCKLEBERRY LN","madd2":"","madd3":"","mcity":"MARSTONS MLS","mstate":"MA","mzip":"02648","pcpfaxno":"","pcpnpi":1780877233,"currentgendcomment":"","pphycomment":"","uniqueid":93963850,"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":["R99","K219","E1165","I10","E291","Z1211","K648","D124","Z83719","F4323","F429","F411","F329","F331","Z0001","E119","Z7984","Z7985","E669","Z6834","Z1331","Z1339","E781","F418","N401","J069","Z0000","E66812","Z6836","L603","E1149","L84","L918","L821","L738","D1801","Z7189","D485","D2339","K635","K649","D126"],"date":["2025-12-29","2025-11-24","2025-10-02","2025-09-16","2025-12-06","2025-09-16","2025-09-16","2025-09-16","2025-09-16","2024-12-03","2025-12-03","2025-12-03","2025-12-03","2025-11-06","2024-03-25","2024-03-25","2024-03-25","2024-03-25","2024-03-25","2024-03-25","2025-06-08","2025-03-04","2025-06-27","2025-03-04","2025-06-27","2024-12-26","2025-03-04","2025-03-04","2025-03-04","2025-07-29","2025-07-29","2025-07-29","2025-09-09","2025-09-09","2025-09-09","2025-09-09","2025-09-09","2025-09-09","2025-09-09","2025-09-16","2025-09-16","2025-09-16"],"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":[["","","TESTOSTERONE CYPIONATE","","","Select","Select",""],["","","GLIMEPIRIDE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","GEMFIBROZIL","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","REGULAR BEVEL NEEDLES","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ARIPIPRAZOLE","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","ECONAZOLE NITRATE","","","Select","Select",""],["","","SPIKEVAX 2025-2026 (12Y UP)","","","Select","Select",""],["","","FLUCELVAX 2025-2026","","","Select","Select",""],["","","SAFETYGLIDE NEEDLE","","","Select","Select",""],["","","FLUZONE TRIVALENT 2024-2025","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","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":""}]}]}