{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James Hall","gend":0,"currentgend":"","add":"16 BALMORAL ST","city":"ANDOVER","state":"MA","zip":"01810","dob":"1961-10-21","age":"","mstatus":"","insh":"C0022655100","cliId":"","pno":6032338484,"cno":"","email":"","ename":"","eno":"","pphy":"Ayobami O Ojutalayo","ppno":9786551987,"pcpadd":"242 Sutton St,","pcpcity":"North Andover","pcpstate":"MA","pcpzip":"01845","pcpcounty":"","pcpid":"","pcpname":"Access Primary Care Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"UNIT 317","add3":"","madd1":"16 BALMORAL ST","madd2":"UNIT 317","madd3":"","mcity":"ANDOVER","mstate":"MA","mzip":"01810","pcpfaxno":"","pcpnpi":1396907812,"currentgendcomment":"","pphycomment":"","uniqueid":104164700,"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":["F329","F419","I10","R99","R062","R059","R41840","L03011","F17200","F331","F411","M7989","F418","Z8619","L400","R5383","Z59811"],"date":["2025-11-26","2025-12-22","2025-11-26","2025-11-26","2025-02-25","2025-02-25","2025-06-09","2024-08-02","2024-08-02","2025-11-26","2025-11-26","2024-08-02","2024-08-02","2024-08-02","2024-03-21","2025-05-06","2025-11-26"],"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":[["","","CEPHALEXIN","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ARIPIPRAZOLE","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","ATOMOXETINE HCL","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","BUSPIRONE HCL","","","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":""}]}]}