{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"THERESA A RENYER","gend":1,"currentgend":"","add":"2930 SW Medford Ave","city":"Topeka","state":"KS","zip":"66611","dob":"1938-08-29","age":"","mstatus":"","insh":"K44003892","cliId":"","pno":"2145007408","cno":"","email":"alrenyer9@yahoo.com","ename":"","eno":"","pphy":"BETSY JOHNS","ppno":"7853546000","pcpadd":"601 SW CORPORATE VW","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66604-1301","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"007","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"2930 SW MEDFORD AVE","madd2":"","madd3":"","mcity":"TOPEKA","mstate":"KS","mzip":"666111715","pcpfaxno":"","pcpnpi":"1750302170","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44003892","medicareid":"2FX3T90RC80","medicaidid":"","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":["Z961","I10","E039","I2510","Z951","R7989","B079","E782","D2239","D224","D2261","D2262","D2271","D2272","L821","L814","S299XXA","S2249XA","S2001XA","M1711","M1712","M79642","M7989","I5032","I6523","R600","N1831","I728","S2241XA","R92323","S301XXA","M353","V877XXD","I77819","Z1339","F439","V877XXA","Z7189","Z515","S2001XD","S2241XD","L03115","L539","L819","D649","D72829","R7402","R7982","N289","V892XXA","S2243XA","D62","T80818A","I959","R54","E8342","E876","M8580","Z66","Z9049","Z9841","Z9842","I252","S301XXD","M2550","M859","N189","S3792XD","Z947","Z9189","Z0000","M810","Z780","L84","Z1231"],"date":["2025-07-14","2025-07-14","2024-09-09","2026-03-16","2026-04-21","2025-09-17","2024-03-05","2026-03-13","2024-05-15","2024-05-15","2024-05-15","2024-05-15","2024-05-15","2024-05-15","2025-09-17","2024-05-15","2024-06-13","2024-06-13","2024-06-17","2024-06-13","2024-06-13","2024-06-13","2024-06-22","2026-04-21","2024-07-16","2024-07-16","2025-09-17","2024-09-10","2024-09-10","2025-12-01","2024-06-29","2024-07-29","2024-08-06","2024-07-02","2024-06-17","2024-06-17","2024-06-17","2024-06-13","2024-06-13","2024-07-29","2024-06-26","2024-06-26","2024-06-22","2024-06-22","2024-06-22","2024-06-22","2024-06-22","2024-06-22","2024-06-17","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2024-07-29","2024-07-29","2024-07-29","2024-07-29","2024-06-18","2025-07-14","2025-08-05","2025-09-17","2026-03-13","2025-12-01","2025-03-11","2025-12-01"],"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":[["","","ATORVASTATIN CALCIUM","40 MG","","Select","Select",""],["","","METOPROLOL TARTRATE","25 MG","","Select","Select",""],["","","FLUOROMETHOLONE","0.10%","","Select","Select",""],["","","COMIRNATY 2025-26","3 ML","","Select","Select",""],["","","AREXVY","120 MCG","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","0.10%","","Select","Select",""],["","","COMIRNATY 2024-25","","","Select","Select",""],["","","PREDNISONE","20 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":""}]}]}