{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DONNA J HULTMAN","gend":1,"currentgend":"","add":"2022 TERRACE DR","city":"NEWTON","state":"KS","zip":"67114","dob":"1955-03-02","age":"","mstatus":"","insh":"7WK4JR8VX05","cliId":"","pno":"9705905543","cno":"","email":"PULLET450@GMAIL.COM","ename":"","eno":"","pphy":"KESHA CRICHLOW","ppno":"3162836103","pcpadd":"720 MEDICAL CENTER DR","pcpcity":"NEWTON","pcpstate":"KS","pcpzip":"67114-8778","pcpcounty":"","pcpid":"","pcpname":"PRIMARY CARE PARTNERS HMC","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":1154746782,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7WK4JR8VX05","medicaidid":"7WK4JR8VX05","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":[]},{"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":[["","","Mesalamine Cap","0.375 GM","","Select","Select",""],["","","Methylpred Tab","4 MG","","Select","Select",""],["","","Estradiol Cre 0.01%","","","Select","Select",""],["","","Fluticasone Spr","50 MCG","","Select","Select",""],["","","Montelukast Tab","10 MG","","Select","Select",""],["","","Cyclobenzapr Tab","5 MG","","Select","Select",""],["","","Ezetimibe Tab","10 MG","","Select","Select",""],["","","Solifenacin Tab","10 MG","","Select","Select",""],["","","Escitalopram Tab","10 MG","","Select","Select",""],["","","Ramelteon Tab","8 MG","","Select","Select",""],["","","Fenofibric Cap","135 MG","","Select","Select",""],["","","Estradiol Tab","10 MCG","","Select","Select",""],["","","Arnuity Elpt Inh","200 MCG","","Select","Select",""],["","","Fluticas Fur Inh","200 MCG","","Select","Select",""],["","","Gabapentin Cap","300 MG","","Select","Select",""],["","","Amitriptylin Tab","10 MG","","Select","Select",""],["","","Clopidogrel Tab","75 MG","","Select","Select",""],["","","Rosuvastatin Tab","5 MG","","Select","Select",""],["","","Pantoprazole Tab","40 MG","","Select","Select",""],["","","Myrbetriq Tab","25 MG","","Select","Select",""],["","","Omeprazole Cap","40 MG","","Select","Select",""],["","","Albuterol Aer Hfa","","","Select","Select",""],["","","Azithromycin Tab","250 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":""}]}]}