{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda Kelley","gend":1,"currentgend":"","add":"9 GRANT ST","city":"TAUNTON","state":"MA","zip":"02780","dob":"1969-05-09","age":"","mstatus":"","insh":"C0025111800","cliId":"","pno":7744060286,"cno":"","email":"","ename":"","eno":"","pphy":"Jennifer L Byrnes","ppno":5085893775,"pcpadd":"8 Commerce Blvd,","pcpcity":"Middleboro","pcpstate":"MA","pcpzip":"02346","pcpcounty":"","pcpid":"","pcpname":"Medical Care of Boston Management Corp.","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"APT 2","add3":"","madd1":"9 GRANT ST","madd2":"APT 2","madd3":"","mcity":"TAUNTON","mstate":"MA","mzip":"02780","pcpfaxno":"","pcpnpi":1083154710,"currentgendcomment":"","pphycomment":"","uniqueid":108347800,"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":["E669","I10","R7303","R635","R7309","K909","M79602","R739","D509","R5381","R600","R062","H66001","J029","J309","R070","J370","R053","K219","R110","K529","R197","R198","R109","R1084","A09","R1031","R42","K760","M25551","M7061","K449","A084","J0190","B9789","A0471","E559","Z01419","M6289","R29890","Z1211","Z90710","N951","N952","R399","M79641","Z1339","M069","E66811","R1010","Z6834","R059","G4733","J069","L821","L820","L2989","R208","L538","Z1331","Z0000","Z139","J4520","B351","L600","M79672","Z800","Z803","Z8249","R99","H66002","M5450","R1033","Z1231","R0602","Z130","F4322","R0600","J45909","E6601"],"date":["2025-09-07","2025-10-11","2025-10-11","2024-05-25","2024-05-25","2024-05-25","2024-07-17","2024-07-17","2024-08-02","2024-07-17","2024-07-17","2025-06-19","2024-02-06","2024-02-06","2024-02-06","2024-08-07","2024-08-07","2024-09-07","2024-07-17","2024-10-25","2024-05-11","2024-05-11","2024-05-11","2025-10-08","2024-03-11","2024-05-11","2024-05-11","2024-05-11","2024-11-19","2024-02-12","2025-09-25","2024-03-11","2024-05-11","2025-01-16","2025-01-16","2024-05-12","2025-02-18","2025-02-18","2025-02-18","2025-02-18","2025-02-18","2025-02-18","2025-02-18","2025-02-18","2025-02-08","2025-06-05","2025-07-08","2025-10-11","2025-10-11","2025-10-08","2025-10-11","2025-06-19","2025-10-11","2025-06-19","2025-07-11","2025-07-11","2025-07-11","2025-07-11","2025-07-11","2025-10-11","2025-10-11","2025-10-11","2025-10-11","2025-11-26","2025-11-26","2025-11-26","2025-11-26","2025-11-26","2025-11-26","2025-12-16","2025-12-30","2024-11-19","2024-03-11","2025-01-29","2025-06-19","2025-10-11","2025-01-14","2024-02-15","2024-09-05","2024-09-05"],"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":[["","","LISINOPRIL","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","WEGOVY","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","DICYCLOMINE HCL","","","Select","Select",""],["","","VANCOMYCIN HCL","","","Select","Select",""],["","","ZEPBOUND","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","BENZONATATE","","","Select","Select",""],["","","VENTOLIN HFA","","","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":""}]}]}