{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kimberly S Reilly","gend":1,"currentgend":"","add":"50 BRIDGE RD","city":"ORLEANS","state":"MA","zip":"02653","dob":"1970-07-22","age":"","mstatus":"","insh":"C0021706100","cliId":"","pno":5082551934,"cno":"","email":"","ename":"","eno":"","pphy":"Timothy C Reed","ppno":5082558825,"pcpadd":"204 Main St,","pcpcity":"Orleans","pcpstate":"MA","pcpzip":"02653","pcpcounty":"","pcpid":"","pcpname":"Medical Affiliates of Cape Cod, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"50 BRIDGE RD","madd2":"","madd3":"","mcity":"ORLEANS","mstate":"MA","mzip":"02653","pcpfaxno":"","pcpnpi":1457320632,"currentgendcomment":"","pphycomment":"","uniqueid":101628450,"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":["F419","T753XXA","K2100","M549","K2950","T753XXD","L309","M62838","G4700","R99","E66812","E66811","M170","R42","M79662","R051","R509","K219","K2289","K2970","Z800","R12","N3000","H938X1","R0981","L578","D485","L821","D2321","S40911A","M25562","Z20822","F32A","G8929","E782","E669","Z6835","K2080","Z6836","Z6834","Z6832","E6609","Z6831","M25572","Z6830","E663","Z6829"],"date":["2025-10-14","2024-03-18","2024-12-06","2024-12-08","2025-12-02","2025-07-21","2024-06-09","2024-06-09","2025-04-14","2025-11-25","2025-01-21","2025-10-27","2024-11-03","2024-11-07","2024-07-03","2024-04-04","2024-04-04","2024-12-06","2024-12-06","2024-12-06","2024-12-06","2024-12-06","2025-11-25","2024-02-16","2024-04-04","2024-10-04","2024-10-04","2024-10-04","2024-10-04","2024-10-04","2024-07-03","2024-02-17","2025-04-14","2025-04-09","2024-06-09","2025-12-02","2024-06-09","2024-12-06","2025-01-17","2025-12-02","2025-04-14","2025-06-13","2025-06-13","2025-04-09","2025-04-09","2025-04-12","2025-04-12"],"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":[["","","SERTRALINE HCL","","","Select","Select",""],["","","SCOPOLAMINE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","ESOMEPRAZOLE MAGNESIUM","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","ZEPBOUND","","","Select","Select",""],["","","CEFUROXIME","","","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":""}]}]}