{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANGELICA L SCHAAL","gend":1,"currentgend":"","add":"135 MICHIGAN ST","city":"LAWRENCE","state":"KS","zip":"66044","dob":"1968-09-12","age":"","mstatus":"","insh":"4MH4KJ3PE88","cliId":"","pno":"7856919609","cno":"","email":"janda5006@gmail.com","ename":"","eno":"","pphy":"AMY BAKER","ppno":7858655300,"pcpadd":"3211 S IOWA ST","pcpcity":"LAWRENCE","pcpstate":"KS","pcpzip":"66046-3956","pcpcounty":"","pcpid":"","pcpname":"LMH HEALTH PRIMARY CARE","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"135 MICHIGAN ST","madd2":"","madd3":"","mcity":"LAWRENCE","mstate":"KS","mzip":"66044","pcpfaxno":"","pcpnpi":1043663396,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4MH4KJ3PE88","medicaidid":"4MH4KJ3PE88","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":[]},{"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":[["","","Fluoromethol Sus 0.1% Op","","","Select","Select",""],["","","Levothyroxin Tab","88 MCG","","Select","Select",""],["","","Cevimeline Cap","30 MG","","Select","Select",""],["","","Albuterol Neb 0.083%","","","Select","Select",""],["","","Oxycodone Tab","10 MG","","Select","Select",""],["","","Ondansetron Tab","4 MG","","Select","Select",""],["","","Famotidine Tab","40 MG","","Select","Select",""],["","","Tamsulosin Cap","0.4 MG","","Select","Select",""],["","","Albuterol Aer Hfa","","","Select","Select",""],["","","Budes\/Formot Aer 160-4.5","","","Select","Select",""],["","","Breyna Aer 160\/4.5","","","Select","Select",""],["","","Zolpidem Tab","10 MG","","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":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"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":""}]}]}