{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Steven Santiago","gend":0,"currentgend":"Male","add":"176 fairmount st","city":"Fitchburg","state":"MA","zip":"01420","dob":"1997-09-30","age":28,"mstatus":"Single","insh":"C0035439900","cliId":"","pno":"7872201985","cno":"","email":"","ename":"","eno":"","pphy":"Shea Goudreau","ppno":9788788100,"pcpadd":"165 Mill St,","pcpcity":"Leominster","pcpstate":"MA","pcpzip":"01453","pcpcounty":"","pcpid":"","pcpname":"Community Health Connections, Inc","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"1R","add3":"","madd1":"176 FAIRMOUNT ST","madd2":"1R","madd3":"","mcity":"Fitchburg","mstate":"MA","mzip":"01420","pcpfaxno":"","pcpnpi":1891299103,"currentgendcomment":"","pphycomment":"","uniqueid":148839750,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["Spanish"]],"comment":[[]],"sub":[]}}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R109","Z79899","H5713","I10","E785","R079","R42","I340","J45909","Z8249","E7800","N451","R002","R0789","J45998","J45901","J101","N50811","G43709","R29818","D751","F411","F4521","J4541","Z6839","Z0189","Z1389","Z1331","R030","Z23","K449","Z8619","K2960","E782","E559","F419","R200","Z6837","K219","E669","Z596","Z6835","Z7951","G44229","M542","R7989","E66811","G43909","F418","L559","R1013","K921","L290","H159","H04123","R519","H43823","R1310","R198","H52223","R300","K5904","J4540","E663","J3089","J029","J069","N50819","R99","M62838","Z6834"],"date":["2025-06-03","2025-12-24","2025-06-30","2025-12-03","2025-06-30","2025-07-07","2025-07-07","2025-07-07","2025-07-07","2025-07-07","2025-07-07","2025-11-07","2025-11-20","2025-11-20","2025-12-02","2025-12-24","2025-12-24","2025-12-04","2026-01-06","2026-01-06","2026-01-23","2025-12-22","2025-11-12","2025-11-04","2025-03-04","2025-03-04","2025-01-28","2025-05-06","2025-02-25","2025-12-02","2025-03-04","2025-03-04","2025-11-04","2025-09-05","2025-06-10","2025-06-10","2025-02-17","2025-03-25","2025-06-27","2025-03-21","2025-04-22","2025-03-21","2025-04-22","2025-04-22","2025-04-22","2025-04-22","2025-04-22","2025-04-22","2025-05-06","2025-05-06","2025-06-09","2025-06-11","2025-06-02","2025-06-26","2025-06-30","2025-06-30","2025-06-30","2025-06-27","2025-06-27","2025-08-15","2025-09-15","2025-12-03","2025-12-03","2025-12-02","2025-12-02","2025-12-23","2025-12-23","2026-01-08","2025-12-24","2025-09-05","2025-04-22"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","","","","","","","","","","","",""],"comment":["","","","","","","","","","","","",""],"sub":[]}}]},{"t":"Self-Assessment and Social History (SDOH)","q":[{"a":{"indx":["","","","1",""],"comment":["","","","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","","","no"],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"score":[0,0,0,0]}},{"a":{"indx":["","1","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"arr":["I am currently employed"],"comment":[]},{"a":{"indx":["","","1"],"comment":["","",""],"score":[0,0,0,0]}},{"a":{"indx":["","","1"],"comment":["","",""],"score":[0,0,0,0]}},{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":[{"indx":["1",""],"comment":["",""],"sub":[]}]},{"a":{"indx":["","1",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","1",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","1",""],"comment":["","",""],"sub":[]}},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":{"indx":["","","1"],"comment":["","",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false,false,false,false,false],"comment":["","","","","","","","",""],"score":["","","","","","","","",""]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[["","",""],["","",""],["","",""],["","",""],["","",""],["","",""]]}]},{"t":"Medical History","q":[{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[],"textValue":""}}},{"index":-1,"comment":"","sub":[]},{"a":[{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","","","","","","","","","","","",""],"comment":["","","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","","","","",""],"comment":["","","","","","",""],"sub":[]}}]},{"t":"Family History","q":[{"index":-1,"comment":"","sub":[]}]},{"t":"Preventive Care","q":[{"a":[["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],{"comment":""}]},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"t":"Allergies \/ Medications","q":[{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"comment":"","sub":[["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["asthma","","WIXELA INHUB","","","Select","Select",""],["asthma","","ALBUTEROL SULFATE","","","Select","Select",""],["asthmabrochodilatorasthmabrochodilatorasthmabrochodilatorasthmabrochodilatorasthmabrochodilatorasthmabrochodilator","","IPRATROPIUM-ALBUTEROL","","","Select","Select",""],["hypertension","","AMLODIPINE BESYLATE","","","Select","Select",""],["chronic asthma","","MONTELUKAST SODIUM","","","Select","Select",""],["","","VITAMIN D2","","","Select","Select",""],["htn","","VALSARTAN","","","Select","Select",""],["acid refkux","","OMEPRAZOLE","","","Select","Select",""],["muscle relaxant","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["antidressant","","ESCITALOPRAM OXALATE","","","Select","Select",""],["hyperlipidemia","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["anxiery","","PROCHLORPERAZINE MALEATE","","","Select","Select",""],["antidepressant","","VENLAFAXINE HCL ER","","","Select","Select",""],["antipariciti","","ALBENDAZOLE","","","Select","Select",""],["gerd","","RABEPRAZOLE SODIUM","","","Select","Select",""],["antidressant","","SERTRALINE HCL","","","Select","Select",""],["migraine","","SUMATRIPTAN SUCCINATE","","","Select","Select",""],["asrhma","","PREDNISONE","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["pain","","KETOROLAC TROMETHAMINE","","","Select","Select",""]]}},{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[],"textValue":""}}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":[false,false,false,false,false,false],"comment":["","","","","",""],"score":["","","","","",""]}},{"a":{"indx":[false],"comment":[""],"score":[""]}}]},{"t":"Assessment of Diagnoses","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false,false,false],"comment":["","","","","","","","",""],"score":["","","","","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false,false],"comment":["","","","","","","",""],"score":["","","","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}],"phq":[{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"subGroup":[{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","","","",""],"comment":["","","","","","",""]},{"indx":["","","","","",false],"comment":[""]}]}]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":[false,false,false,false,false,false],"comment":["","","","","",""],"score":["","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false],"comment":["","","","","","",""],"score":["","","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false],"comment":["","","","","","",""],"score":["","","","","","",""]}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Pain","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]]}}]},{"t":"Vital Signs","q":[{"a":["","","","","","","",false,false,false]},{"a":["","","","",{"txt":""},{"malnutrition":{"indx":["","","","","","",""],"sub":{"indx":[],"comment":[],"sub":[]}}}]},{"a":{"indx":["","","","","","","","","","","",""],"comment":["","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}},{"arr":[],"comment":[]},{"arr":[],"comment":[]},{"a":{"indx":["","","","","","","","",""],"comment":["","","","","","","","",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Exam Review","q":[{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":[""],"comment":[""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"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":{"indx":[false,false,false],"comment":["","",""],"score":["","",""]}}]},{"t":"Mini-Cog","q":[{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":{"data":["","1","","","","0"],"indx":[false,false,false,false,false,false,false,false,false,false,false,false,false,false,false,false,false,false],"version":[false,false,false,false,false,false]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Home Safety & Personal Goals","q":[{"a":{"indx":["","","","",""],"comment":["","","","",""],"score":[0,0,0,0]}},{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":[""]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":[""]},{"arr":[],"comment":[]},{"a":{"indx":["","","","","","","","","","",""],"comment":["","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"2026-06-11T11:30","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"Virtual Interpreter","a10":[],"a11":"","a12":"","a13":"","a14":"","a16":"","a18":"","a19":"","a20":"","a21":""}]}]}