{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Carole Denesha","gend":1,"currentgend":"","add":"191 MAIN ST","city":"WEST DENNIS","state":"MA","zip":"02670","dob":"1962-06-05","age":"","mstatus":"","insh":"C0020574500","cliId":"","pno":5087373233,"cno":"","email":"","ename":"","eno":"","pphy":"Kelly King","ppno":5084321400,"pcpadd":"710 Route 28,","pcpcity":"Harwich Port","pcpstate":"MA","pcpzip":"02646","pcpcounty":"","pcpid":"","pcpname":"Outer Cape Health Services","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"APT E","add3":"","madd1":"191 MAIN ST","madd2":"APT E","madd3":"","mcity":"WEST DENNIS","mstate":"MA","mzip":"02670","pcpfaxno":"","pcpnpi":1063049062,"currentgendcomment":"","pphycomment":"","uniqueid":99525650,"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":["E119","E7800","E038","E538","E559","Z7689","F418","Z122","Z79899","F17200","F419","F39","F900","R233","F5101","Z1231","R58","F17210","Z0000","J42","Z1211","D696","L814","D225","L821","L578","D692","L853","Z7189","L820","L538","D649","D122","K5730","R942","R0609","Z87891","R918","B349","J029","R519","L539","Z20822","J449","D7589","Z860100","J069","R5383","M7910","K760","R7301","Z23","I2510","F1010","C541","D539","K056","R0602","S61411A","Z8542","L299","R931","I340","I351","I361","I371","E039","L0101","L309","L500","M21611","E782","R99","F902","F411","F331","L0100","M7501","G4700","F1021","Z8659","F17201","M7581"],"date":["2024-09-05","2025-10-30","2025-11-12","2024-09-05","2024-09-05","2024-09-05","2024-09-05","2025-02-07","2024-11-21","2025-10-07","2025-07-01","2025-12-19","2025-12-19","2025-06-24","2025-11-24","2025-07-21","2024-10-06","2024-06-20","2024-06-13","2024-09-07","2025-10-23","2025-04-02","2024-08-29","2024-08-29","2025-09-18","2025-09-18","2025-11-02","2025-09-18","2024-08-29","2025-09-18","2025-09-18","2025-07-17","2025-10-23","2025-10-23","2024-10-15","2024-10-15","2025-06-24","2024-10-15","2024-11-13","2024-11-13","2024-11-13","2024-11-13","2025-01-10","2025-08-23","2024-11-18","2025-11-13","2024-12-13","2024-12-13","2024-12-13","2025-11-02","2025-02-18","2025-11-13","2025-09-25","2024-08-13","2025-06-24","2025-07-14","2025-11-13","2025-09-24","2025-10-28","2025-08-23","2025-09-18","2025-11-13","2025-11-13","2025-09-24","2025-09-24","2025-09-24","2025-01-10","2025-10-28","2025-11-18","2025-11-13","2025-11-13","2024-05-05","2025-08-28","2024-12-03","2025-12-27","2024-06-21","2025-09-10","2024-06-03","2024-06-21","2025-11-11","2025-11-11","2025-11-11","2024-03-27"],"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":[["","","NICOTINE PATCH","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","ARIPIPRAZOLE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","LAMOTRIGINE","","","Select","Select",""],["","","DEXTROAMPHETAMINE-AMPHET ER","","","Select","Select",""],["","","GAVILYTE-G","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","DIAZEPAM","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","MOMETASONE FUROATE","","","Select","Select",""],["","","METHYLPHENIDATE ER","","","Select","Select",""],["","","DEXTROAMPHETAMINE-AMPHETAMINE","","","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":""}]}]}