{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NANCY K LITTLE","gend":1,"currentgend":"","add":"1010 NW Lyman Rd","city":"Topeka","state":"KS","zip":"66608","dob":"1956-04-28","age":"","mstatus":"","insh":"K44002853","cliId":"","pno":"7852498452","cno":"","email":"TLITTLE358@COX.NET","ename":"","eno":"","pphy":"JESSICA POELL","ppno":"3162022110","pcpadd":"345 N RIVERVIEW ST","pcpcity":"WICHITA","pcpstate":"KS","pcpzip":"67203-4267","pcpcounty":"","pcpid":"","pcpname":"LEVEL WELLNESS MIND","plan":"BCBSKS","program":"Medicare","lob":"007","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1972067403","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44002853","medicareid":"7W03GX2MM88","medicaidid":"7W03GX2MM88","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":["E782","J4520","F418","E559","F411","D3131","H2513","H524","R29818","I639","I10","M810","Z1231","B001","G479","R3589","R5383","R4586","N3281","J4530","J22","Z888","Z880","Z881","M818","H401122","H401131","H5212","H52223","Z130","Z13228","E538","R351","R109","R531","M25551","R92333","M47816","M5416","M5431","M48061","M4316","N952","M25452","M51369","D485","Z0130","Z85828","R9431","B079","R42"],"date":["2025-01-09","2024-11-22","2025-01-09","2025-01-09","2024-09-26","2024-03-28","2025-08-21","2025-08-21","2024-04-02","2024-04-02","2024-11-22","2025-01-28","2024-11-22","2024-11-22","2024-12-12","2024-12-12","2024-12-12","2024-12-12","2024-12-12","2025-01-28","2024-12-17","2024-04-02","2024-04-02","2024-04-02","2025-07-17","2025-08-26","2025-08-21","2025-08-21","2025-08-21","2025-01-09","2025-01-09","2025-01-09","2025-01-09","2025-01-09","2025-01-09","2025-05-16","2025-01-16","2025-06-04","2025-01-18","2025-05-09","2025-06-04","2025-06-04","2025-06-06","2025-06-04","2025-06-04","2026-02-23","2026-06-08","2026-06-08","2026-04-02","2026-06-08","2026-06-11"],"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":[["","","TRAVOPROST","0.00%","","Select","Select",""],["","","LISINOPRIL","20 MG","","Select","Select",""],["","","PREDNISONE","5 MG","","Select","Select",""],["","","OXYCODONE HYDROCHLORIDE","5 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","12.5 MG","","Select","Select",""],["","","TIZANIDINE HYDROCHLORIDE","4 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40 MG","","Select","Select",""],["","","ALENDRONATE SODIUM","70 MG","","Select","Select",""],["","","ESTRADIOL","0.01%","","Select","Select",""],["","","Prednisone Tab","50 MG","","Select","Select",""],["","","Hydrochlorot Cap","12.5 MG","","Select","Select",""],["","","Travoprost Dro 0.004%","","","Select","Select",""],["","","Estradiol Cre 0.01%","","","Select","Select",""],["","","Tizanidine Tab","4 MG","","Select","Select",""],["","","Pantoprazole Tab","40 MG","","Select","Select",""],["","","Lisinopril Tab","20 MG","","Select","Select",""],["","","Oxycodone Tab","5 MG","","Select","Select",""],["","","Alendronate Tab","70 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":""}]}]}