{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KAREN M SAGELY","gend":1,"currentgend":"","add":"900 SW Robinson Ave","city":"Topeka","state":"KS","zip":"66606","dob":"1961-12-10","age":"","mstatus":"","insh":"K44005831","cliId":"","pno":"7854711889","cno":"","email":"ksagely@gmail.com","ename":"","eno":"","pphy":"ALAN ZAPATA","ppno":"7852959401","pcpadd":"2641 SW WANAMAKER RD","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66606-1678","pcpcounty":"","pcpid":"","pcpname":"TOPEKA PHYSICIAN GROUP LLC","plan":"BCBSKS","program":"Medicare","lob":"001","region":"","aligned":"","ano":"","add2":"Apt 603","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"7853792457","pcpnpi":"1134658321","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44005831","medicareid":"8HE7JX3FT36","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":["I4710","I4720","I10","N1832","E782","Z95810","E785","I480","E6601","F331","Z7901","F411","I4901","I4891","Z6843","R92333","E1122","L989","L570","Z1329","I129","Z8679","G4733","N182","Z7984","Z7189","I252","Z79899","R053","Z1159","F4310","F4010","F422","M79641","M25561","Z98890","F329","Z1231","S8001XA","W010XXA","I2589","R2689","R29898","R0602","I3481","D72829","R8281","B351","Z124","H43813","H2513","H25013","Z950","M25462","R92323","H35373"],"date":["2026-05-28","2025-05-26","2026-05-28","2025-12-04","2025-12-04","2026-05-28","2026-05-28","2025-12-04","2025-05-26","2026-05-14","2025-11-24","2026-06-11","2025-10-02","2024-07-11","2024-09-11","2024-09-10","2025-12-04","2025-01-03","2025-02-26","2024-10-18","2024-10-15","2026-05-28","2026-05-28","2025-02-06","2024-10-24","2024-10-31","2024-01-31","2024-01-31","2024-09-17","2024-09-17","2026-06-11","2026-05-14","2025-11-17","2025-10-16","2025-10-16","2025-10-16","2025-12-04","2025-12-04","2025-10-16","2025-10-16","2026-05-28","2025-12-04","2025-12-04","2025-12-17","2025-12-17","2025-02-26","2025-02-06","2025-01-03","2025-02-26","2026-03-03","2026-03-03","2025-02-25","2025-07-09","2025-05-30","2026-01-02","2026-03-03"],"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":[["","","ELIQUIS","5 MG","","Select","Select",""],["","","BUSPIRONE HYDROCHLORIDE","15 MG","","Select","Select",""],["","","PIOGLITAZONE HYDROCHLORIDE","15 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","40 MG","","Select","Select",""],["","","SPIRONOLACTONE","25 MG","","Select","Select",""],["","","METOPROLOL TARTRATE","100 MG","","Select","Select",""],["","","FLECAINIDE ACETATE","100 MG","","Select","Select",""],["","","LOSARTAN POTASSIUM","100 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","DESVENLAFAXINE ER","100 MG","","Select","Select",""],["","","BUPROPION HYDROCHLORIDE ER (XL)","300 MG","","Select","Select",""],["","","OZEMPIC","2 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":""}]}]}