{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BARBARA A PARKHURST","gend":1,"currentgend":"","add":"5000 CLINTON PKWY","city":"LAWRENCE","state":"KS","zip":"66047","dob":"1945-03-26","age":"","mstatus":"","insh":"K44001444","cliId":"","pno":"7029067190","cno":"","email":"jhlj4grands@gmail.com","ename":"","eno":"","pphy":"AMANDA COLGAN","ppno":"7853549591","pcpadd":"823 SW MULVANE ST","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66606-2442","pcpcounty":"","pcpid":"","pcpname":"LAWRENCE PAIN SPECIALISTS","plan":"BCBSKS","program":"Medicare","lob":"001","region":"","aligned":"","ano":"","add2":"APT 1012","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"7855055319","pcpnpi":"1114047453","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44001444","medicareid":"4MG4D13GJ61","medicaidid":"4MG4D13GJ61","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R7989","R7303","R809","E6609","Z6834","M79641","M79642","M79644","M7989","I10","E785","R768","R7301","E669","Z6833","Z7689","M25542","M25641","M25642","R600","Z800","M19042","R42","M8589","M19041","G5603","R591","R791","R2242","Z01818","L03116","I872","I4510","M8580","R599","E663","Z6831","Z556","Z741"],"date":["2026-02-12","2026-04-17","2024-02-20","2024-02-20","2024-02-20","2026-01-28","2026-01-28","2024-04-22","2026-02-19","2026-02-17","2026-04-17","2024-06-10","2024-06-10","2024-06-10","2024-06-10","2026-06-08","2025-10-08","2025-10-08","2025-10-08","2026-02-19","2025-10-02","2026-04-17","2025-11-26","2025-10-08","2026-04-17","2026-01-30","2026-01-30","2026-02-12","2026-02-12","2026-01-30","2026-02-12","2026-04-17","2026-04-17","2026-04-17","2026-04-17","2026-04-17","2026-04-17","2026-04-17","2026-04-17"],"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":[["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","FLUCONAZOLE","100 MG","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","10 MEQ","","Select","Select",""],["","","MELOXICAM","7.5 MG","","Select","Select",""],["","","FLUAD 2025-2026","","","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":""}]}]}