{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TROY R MYER","gend":0,"currentgend":"","add":"614 AUGUSTINE ST","city":"HUTCHINSON","state":"KS","zip":"67501","dob":"1971-10-29","age":"","mstatus":"","insh":"52161842457018","cliId":"","pno":6209600890,"cno":"","email":"TRYMYR@YAHOO.COM","ename":"","eno":"","pphy":"ROBERT ULLOM","ppno":3167214544,"pcpadd":"8200 W CENTRAL AVE","pcpcity":"WICHITA","pcpstate":"KS","pcpzip":"67212","pcpcounty":"","pcpid":"","pcpname":"","plan":"BCBSKS","program":"ACA","lob":"INDIVIDUAL METALLIC","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"614 AUGUSTINE ST","madd2":"","madd3":"","mcity":"HUTCHINSON","mstate":"KS","mzip":"67501","pcpfaxno":"          ","pcpnpi":1902034614,"currentgendcomment":"","pphycomment":"","uniqueid":"XSN872672314","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R040","J3489","L2089","Z932","K50813","R7401","K838","K8301","K831","D509","C178","Z08","Z85828","D492","M546","M9902","M5450","M542","M9905","M9901","L821"],"date":["2026-03-26","2026-03-26","2026-03-24","2026-04-16","2026-04-21","2026-04-21","2026-04-21","2026-04-21","2026-04-21","2026-04-21","2026-04-20","2026-02-17","2026-02-17","2026-02-17","2026-02-16","2026-02-16","2026-02-16","2026-02-16","2026-02-16","2026-02-16","2026-02-17"],"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":[["","","MUPIROCIN","","","Select","Select",""],["","","URSODIOL","","","Select","Select",""],["","","VERAPAMIL ER","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","TACROLIMUS","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","DOXEPIN 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":""}]}]}