{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Tatiana J Brainerd","gend":1,"currentgend":"","add":"6 GERALD RD","city":"STONEHAM","state":"MA","zip":"02180","dob":"1973-02-26","age":"","mstatus":"","insh":"C0037089100","cliId":"","pno":7819104252,"cno":"","email":"","ename":"","eno":"","pphy":"Kristyn Newhall","ppno":7813387400,"pcpadd":"178 Savin St,Ste 100","pcpcity":"Malden","pcpstate":"MA","pcpzip":"02148","pcpcounty":"","pcpid":"","pcpname":"Hallmark Health Medical Associates","plan":"Wellsense Health Plan","program":"ACA","lob":"Commercial - MA - Wave 1","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"6 GERALD RD","madd2":"","madd3":"","mcity":"STONEHAM","mstate":"MA","mzip":"02180","pcpfaxno":"","pcpnpi":1275760027,"currentgendcomment":"","pphycomment":"","uniqueid":150923100,"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":["R1031","R300","N3000","R233","D259","L237","Z87892","R062","L270","Z01419","I728","N939","Z3202","E559","Z0000","Z1331","H9313","F902","Z1211","K5730","K648","M79605","M25562","N898","F0781","Z1231","F419","F32A","R99","K219"],"date":["2025-03-24","2025-03-19","2025-03-19","2025-03-24","2025-03-24","2025-04-24","2025-04-24","2025-04-24","2025-04-24","2025-05-07","2025-06-02","2025-05-22","2025-05-22","2025-06-02","2025-06-02","2025-06-02","2025-06-02","2026-02-12","2025-06-11","2025-06-11","2025-06-11","2025-07-14","2025-07-14","2025-12-02","2025-12-02","2025-12-02","2025-12-13","2025-12-02","2025-09-12","2025-06-11"],"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":[["","","METHYLPHENIDATE HCL","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","DEXMETHYLPHENIDATE HCL ER","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","FLUBLOK 2025-2026","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","ESTRADIOL","","","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":""}]}]}