{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michela A Parmeggiani","gend":1,"currentgend":"","add":"30 Pierce Street","city":"Stoughton","state":"MA","zip":"02072","dob":"1995-09-15","age":"","mstatus":"","insh":"C0030198800","cliId":"","pno":7812910529,"cno":"","email":"","ename":"","eno":"","pphy":"Juliana Bahia Mazzafera","ppno":5088948730,"pcpadd":"31 Roche Brothers Way,Suite 210","pcpcity":"North Easton","pcpstate":"MA","pcpzip":"02356","pcpcounty":"","pcpid":"","pcpname":"Signature Healthcare Medical Group, Inc.","plan":"Wellsense Health Plan","program":"ACA","lob":"ACA - Rollover - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"30 Pierce Street","madd2":"","madd3":"","mcity":"Stoughton","mstate":"MA","mzip":"02072","pcpfaxno":"","pcpnpi":1588152631,"currentgendcomment":"","pphycomment":"","uniqueid":139361600,"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":["F411","F4311","F5081","F603","F3181","F330","F410","F4001","E039","M65131","E669","Z6830","F909","E785","H538","Z87891","Z1331","Z833","Z8249","M25531","M67833","Z91013","Z98890","Z8349","M778","Z83438","F1290","N760","Z124","N72","Z0101","H4710","G43101","H5213","Z973","Z975","Z8781","M65841","Z0000","Z23","R946","E559","D229","Z6832","M67831","H469","H47093","G971","R519","Y844","Z793","Z79890","R0683","F32A","Z6833","G43909","S60851D","Z1389","S60851A","D225","D2372","R238","Z9109","Z01419","M5450","J029","M549","Z6831","Z1152","Z1159","Z79891"],"date":["2025-09-30","2025-09-10","2024-11-06","2025-12-09","2024-11-06","2025-09-10","2024-11-06","2025-09-10","2025-12-09","2024-08-03","2025-12-09","2025-09-12","2025-12-09","2025-12-09","2025-02-25","2024-08-21","2025-09-12","2025-07-04","2025-03-28","2025-03-28","2024-03-19","2025-07-04","2025-07-04","2024-08-21","2025-07-04","2024-08-04","2024-08-04","2024-09-04","2024-09-04","2024-09-04","2024-08-16","2024-08-16","2024-08-16","2024-08-16","2025-07-04","2024-08-21","2024-08-21","2024-06-09","2025-09-12","2024-09-27","2024-09-27","2024-09-27","2025-12-09","2025-12-09","2024-06-09","2025-12-09","2025-04-02","2025-03-24","2025-03-24","2025-03-24","2025-03-24","2025-03-24","2025-05-30","2025-12-09","2025-05-30","2025-10-11","2025-05-13","2025-05-30","2025-05-13","2025-06-08","2025-06-08","2025-06-08","2025-06-08","2025-02-09","2025-12-09","2025-10-16","2025-10-16","2025-10-16","2025-10-16","2025-10-16","2025-09-12"],"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":[["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","PHENTERMINE HCL","","","Select","Select",""],["","","LISDEXAMFETAMINE DIMESYLATE","","","Select","Select",""],["","","ETONOGESTREL-ETHINYL ESTRADIOL","","","Select","Select",""],["","","TOPIRAMATE","","","Select","Select",""],["","","BUTALBITAL-ACETAMINOPHEN-CAFFE","","","Select","Select",""],["","","LAMOTRIGINE","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","VYVANSE","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","CYCLOBENZAPRINE 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":""}]}]}