{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lucas Gomez","gend":0,"currentgend":"","add":"46 KEARSARGE ST","city":"NEW BEDFORD","state":"MA","zip":"02745","dob":"1961-11-28","age":"","mstatus":"","insh":"C0018017901","cliId":"","pno":7749928887,"cno":"","email":"","ename":"","eno":"","pphy":"Than Than Win","ppno":5089926553,"pcpadd":"874 Purchase St,","pcpcity":"New Bedford","pcpstate":"MA","pcpzip":"02740","pcpcounty":"","pcpid":"","pcpname":"Greater New Bedford Community Health Center","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"APT 1","add3":"","madd1":"46 KEARSARGE ST","madd2":"APT 1","madd3":"","mcity":"NEW BEDFORD","mstate":"MA","mzip":"02745","pcpfaxno":"","pcpnpi":1447298054,"currentgendcomment":"","pphycomment":"","uniqueid":94082851,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R1110","R4182","S0990XA","F10129","K920","R000","K922","K7030","K7010","I8511","F10930","F1010","Z91199","Z87891","K766","K3189","R578","Z4682","R0989","R0602","S199XXA","R9089","I6523","Y908","L299","T7840XD","F1020","Z1331","Z139","R310","K2921","K769","R051","M7910","R509","R5383","R110","S61401A","S61402A","R21","R7989","R42","R519","M542","R220","J439","S59901A","S299XXA","S0101XA","S50311A","F10920","I499","K7031","D61818","K529","K7460","E806","D696","D649","R791","R188","K7689","K838","K8020","R109","R161","K828","K7682","R531","R410","E7220","F10239","D6959","Z2989","F10220","F10230","K7290","R040","G319","G9389","S0993XA","G9340","N281","R932","Z789","R079","S3993XA","S3991XA","S0081XA","R99","L2981","R571","Z556","F10229","Z86011","K226","J9601","F10139","D62","K7011","E876","Z781","E8351","E8339","T884XXA","E669","Z6825","R059","Z20822","K2970","Z888","Z79899","K219","K760","Z603","Z1152","I8510","I6200","Z98890","K5900","Z91014","D500","F419","S065XAD","F32A","Z9181","Z136","Z0389","M4852XA","J9811","M47812","M50222","M4802","I959","R918"],"date":["2025-04-01","2026-01-09","2025-09-06","2025-12-02","2025-12-01","2025-05-10","2025-07-12","2025-06-16","2025-06-03","2026-02-04","2025-05-15","2025-12-31","2025-05-11","2025-11-30","2026-02-04","2026-02-04","2025-05-13","2025-05-17","2025-05-17","2025-10-16","2025-11-28","2025-04-30","2025-04-30","2025-04-30","2025-06-16","2025-06-13","2026-02-04","2025-06-16","2025-06-16","2025-06-16","2025-06-16","2025-06-16","2025-07-12","2025-07-12","2025-07-12","2025-07-12","2025-07-12","2025-06-18","2025-06-18","2025-06-18","2025-10-30","2025-10-30","2025-09-06","2025-09-06","2025-09-06","2025-09-06","2025-09-06","2026-01-09","2025-09-06","2025-09-06","2025-09-06","2025-10-16","2026-02-04","2025-12-01","2025-10-20","2025-11-29","2025-10-20","2025-12-01","2025-10-20","2025-12-31","2025-10-20","2025-11-29","2025-10-16","2025-10-16","2025-10-16","2025-10-19","2025-10-20","2026-02-04","2025-10-30","2025-10-29","2025-10-29","2025-12-01","2025-11-28","2025-11-28","2025-11-29","2025-11-29","2025-11-29","2025-12-01","2025-11-28","2025-11-28","2025-11-28","2025-11-29","2025-11-29","2025-11-29","2025-12-12","2026-01-09","2026-01-09","2026-01-09","2025-02-08","2025-12-01","2026-02-10","2025-06-03","2026-02-04","2025-02-09","2025-02-09","2025-10-30","2025-05-10","2025-11-28","2025-05-10","2025-05-10","2025-05-10","2025-05-10","2025-05-10","2025-05-10","2025-05-10","2025-05-10","2025-05-10","2025-07-12","2025-07-12","2025-06-18","2025-11-28","2025-11-28","2026-02-04","2025-10-16","2025-11-28","2025-10-16","2025-11-28","2025-10-30","2025-10-30","2025-10-30","2025-11-28","2026-02-04","2026-02-04","2026-02-04","2026-02-04","2026-02-04","2025-05-11","2025-05-11","2025-05-11","2025-05-11","2025-05-10","2025-05-10","2025-05-10","2025-05-10","2025-05-12"],"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":[["","","FOLIC ACID","","","Select","Select",""],["","","CONSTULOSE","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","XIFAXAN","","","Select","Select",""],["","","LACTULOSE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","NALTREXONE HCL","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","PERMETHRIN","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","SPIRONOLACTONE","","","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":""}]}]}