{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARVIN R JONES","gend":0,"currentgend":"","add":"615 N 17TH ST","city":"PARSONS","state":"KS","zip":"67357","age":"","mstatus":"","insh":"K44008315","cliId":"","pno":"6204219004","cno":"","email":"","ename":"","eno":"","pphy":"YASH PATEL","ppno":"6208205800","pcpadd":"1902 S HWY 59  BLDG E","pcpcity":"PARSONS","pcpstate":"KS","pcpzip":"67357-4948","pcpcounty":"","pcpid":"","pcpname":"LCMC PHYSICIANS GROUP","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1205284601","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44008315","medicareid":"9FN0PY7HJ16","medicaidid":"9FN0PY7HJ16","pcpFlag":"","dob":"1938-09-17"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":{"0":{"a":{"diag":["N1831","Z794","E162","E782","I10","I2510","N1832","Z1339","E1122","R0989","R051","L602","R609","R42","R410","H70002","I130","I509","Z87891","R5383","E785","H7092","H938X2","R9439","Z0130","I110","I440","I493","E119","Z7984","Z79899","Z7982","I2582","H7090","H6092","D72829"],"date":["2026-03-18","2026-03-31","2025-09-15","2025-06-23","2026-03-19","2026-03-19","2026-02-22","2025-06-23","2026-02-25","2025-09-15","2025-09-15","2025-01-02","2025-03-31","2026-05-05","2026-02-22","2026-02-22","2026-02-22","2026-03-31","2026-03-31","2026-03-16","2026-03-31","2026-05-13","2026-03-18","2026-03-19","2026-03-19","2026-03-31","2026-03-31","2026-03-31","2026-03-31","2026-03-31","2026-03-31","2026-03-31","2026-03-31","2026-05-13","2026-05-13","2026-02-22"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},"1":{"a":[]},"3":{"a":{"indx":["1",""],"comment":["",""],"sub":[]}}}},{"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":[["","","DEXCOM G7 SENSOR","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","","","Select","Select",""],["","","AMLODIPINE BESYLATE","10 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","80 MG","","Select","Select",""],["","","AMOXICILLIN","875 MG","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","TOBRAMYCIN SULFATE","0.30%","","Select","Select",""],["","","LOSARTAN POTASSIUM","100 MG","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","100 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS","","","Select","Select",""],["","","METOPROLOL SUCCINATE ER","25 MG","","Select","Select",""],["","","IBUPROFEN","800 MG","","Select","Select",""],["","","NOVOLIN 70\/30 RELION","","","Select","Select",""],["","","OFLOXACIN","","","Select","Select",""],["","","CIPROFLOXACIN\/DEXAMETHASONE","0.10%","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","DEXCOM G7 RECEIVER","","","Select","Select",""],["","","NOVOLIN 70\/30","","","Select","Select",""],["","","ONETOUCH ULTRA","","","Select","Select",""],["","","FREESTYLE LIBRE 2\/SENSOR\/FLASH GLUCOSE MONITORING SYSTEM","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","EMBECTA INSULIN SYRINGE\/ULTRA-FINE\/1ML\/31G X 6MM","1 ML","","Select","Select",""],["","","CAPVAXIVE","0.5 ML","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","Insulin Syrg Mis","1 ML","","Select","Select",""],["","","Cephalexin Cap","500 MG","","Select","Select",""],["","","Fluzone Hd Inj 2025-26","","","Select","Select",""],["","","Onetouch Tes Ultra","","","Select","Select",""],["","","Dexcom G7 Mis Receiver","","","Select","Select",""],["","","Freesty Libr Kit 2 Sensor","","","Select","Select",""],["","","Dexcom G7 Mis Sensor","","","Select","Select",""],["","","Losartan Pot Tab","100 MG","","Select","Select",""],["","","Metoprol Suc Tab","25 MG","","Select","Select",""],["","","Hydrochlorot Tab","25 MG","","Select","Select",""],["","","Atorvastatin Tab","80 MG","","Select","Select",""],["","","Capvaxive Inj","0.5 ML","","Select","Select",""],["","","Novolin Inj 70\/30","","","Select","Select",""],["","","Novolin70\/30 Inj Relion","","","Select","Select",""],["","","Albuterol Aer Hfa","","","Select","Select",""],["","","Amlodipine Tab","10 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":""}]}]}