{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CHARITY M KIPP","gend":1,"currentgend":"","add":"1419 E WARREN CT","city":"DERBY","state":"KS","zip":"67037","dob":"1982-09-04","age":"","mstatus":"","insh":"K44002907","cliId":"","pno":"6189795409","cno":"","email":"charity.kipp@protonmail.com","ename":"","eno":"","pphy":"BRIAN COMER","ppno":"3167770176","pcpadd":"1004 SE LOUIS DR","pcpcity":"MULVANE","pcpstate":"KS","pcpzip":"67110-1109","pcpcounty":"","pcpid":"","pcpname":"FAMILY MEDCENTERS PA","plan":"BCBSKS","program":"Medicare","lob":"007","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1419 E WARREN CT","madd2":"","madd3":"","mcity":"DERBY","mstate":"KS","mzip":"67037","pcpfaxno":"","pcpnpi":"1538155205","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44002907","medicareid":"1JE7F60GH68","medicaidid":"1JE7F60GH68","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z712","Z789","E6601","Z719","K2970","K2980","K6389","R42","D509","R21","Z6841","Z1211","Z1239","D75839","Z23","Z1331","H8109","Q780","K2210","Z0000","Z136","Z1151","Z113","Z124","N907","G4733","R051","R059","R0981"],"date":["2024-01-17","2026-01-09","2026-01-09","2026-01-09","2024-02-07","2024-02-07","2024-02-07","2024-04-08","2024-12-09","2024-04-08","2024-04-08","2024-12-09","2024-12-09","2024-12-09","2024-12-09","2024-12-09","2024-12-09","2024-12-09","2024-12-09","2024-12-09","2024-12-09","2025-01-29","2025-01-29","2025-01-29","2025-01-29","2025-03-13","2025-03-17","2026-01-09","2026-01-09"],"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":[["","","PREDNISONE","20 MG","","Select","Select",""],["","","AMOXICILLIN","875 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":""}]}]}