{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joseph T Silva Jr","gend":0,"currentgend":"","add":"137 LEAHY DR","city":"TAUNTON","state":"MA","zip":"02780","dob":"1964-09-22","age":"","mstatus":"","insh":"C0025638900","cliId":"","pno":7742630957,"cno":"","email":"","ename":"","eno":"","pphy":"Kelly Burke","ppno":5088225500,"pcpadd":"1 Washington St,","pcpcity":"Taunton","pcpstate":"MA","pcpzip":"02780","pcpcounty":"","pcpid":"","pcpname":"Manet Community Health Center, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"137 LEAHY DR","madd2":"","madd3":"","mcity":"TAUNTON","mstate":"MA","mzip":"02780","pcpfaxno":"","pcpnpi":1346852019,"currentgendcomment":"","pphycomment":"","uniqueid":109476450,"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":["K51011","F411","R99","R0602","J4540","I10","E785","K219","L218","J324","L209","J189","J45901","R110","R42","R911","J9811","Z79899","Z7951","R070","K2270","Z8719","G4733","J45909","Z7982","K5100","K5730","K6389","K648","Z886","R053","R0902","J984","J8410","R0789","H5203","H52223","H524","Z8249","I119","R490","J392","J370","J329","R6882","E559","Z0000","Z1211","Z125","R0989","J383","K2289","E663","K2080","R1310","L2089","K529","K630","K3533","K5190","R233","R748","E782","Z9109"],"date":["2025-09-30","2025-11-14","2025-12-03","2024-06-17","2025-10-18","2025-12-22","2025-11-30","2025-12-21","2025-11-01","2025-10-18","2025-11-14","2024-03-13","2024-03-13","2024-03-13","2024-03-13","2024-03-13","2024-03-13","2025-03-14","2024-03-13","2024-08-30","2025-09-30","2025-03-14","2025-03-14","2025-03-14","2025-03-14","2025-03-14","2025-03-14","2025-03-14","2025-03-14","2025-03-14","2025-11-14","2024-03-13","2024-03-13","2024-03-13","2024-03-21","2024-03-28","2024-03-28","2024-03-28","2024-03-21","2024-03-21","2024-08-30","2024-08-30","2024-08-30","2024-04-23","2024-12-08","2024-12-08","2024-12-08","2025-03-14","2024-12-08","2024-08-16","2024-08-16","2024-08-27","2024-10-23","2024-08-28","2024-08-27","2024-12-20","2025-03-17","2025-03-17","2025-03-17","2025-03-17","2025-09-06","2025-09-06","2025-11-14","2025-08-12"],"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":[["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","MESALAMINE","","","Select","Select",""],["","","SPIRIVA RESPIMAT","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","CITALOPRAM HBR","","","Select","Select",""],["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","FLUOCINONIDE","","","Select","Select",""],["","","PEG 3350-ELECTROLYTE","","","Select","Select",""],["","","ARNUITY ELLIPTA","","","Select","Select",""],["","","BUDESONIDE","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","BREO ELLIPTA","","","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":""}]}]}