{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMES E JAROWITZ","gend":0,"currentgend":"","add":"1006 SE 33rd St Ter","city":"Topeka","state":"KS","zip":"66605","age":"","mstatus":"","insh":"K44009064","cliId":"","pno":"7852243308","cno":"","email":"","ename":"","eno":"","pphy":"MARK THOMAS","ppno":"7852670744","pcpadd":"2909 SE WALNUT DR","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66605-2189","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1629086277","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44009064","medicareid":"5U32G06KQ94","medicaidid":"","pcpFlag":"","dob":"1947-08-31"},{"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":["Z7901","E782","J029","E1140","I10","I5022","Z794","I255","E034","E1122","N1831","E039","E1142","M79602","T07XXXA","I5020","I480","H43813","H35371","Z1331","Z0000","H26491","Z9181","I2510","M25511","M25512","G8929"],"date":["2026-06-05","2026-06-18","2025-07-17","2026-03-24","2025-12-23","2025-07-17","2026-03-24","2026-03-20","2026-03-24","2026-03-24","2026-03-24","2025-09-19","2025-10-06","2025-12-04","2025-12-04","2025-12-23","2026-03-24","2026-03-25","2026-03-25","2025-03-19","2025-03-19","2026-03-25","2026-03-24","2026-03-24","2026-03-24","2026-03-24","2026-03-24"],"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",""],["","","ATORVASTATIN CALCIUM","40 MG","","Select","Select",""],["","","JARDIANCE","25 MG","","Select","Select",""],["","","NITROGLYCERIN","0.4 MG","","Select","Select",""],["","","WARFARIN SODIUM","5 MG","","Select","Select",""],["","","IRBESARTAN","150 MG","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","50 MCG","","Select","Select",""],["","","SPIRONOLACTONE","25 MG","","Select","Select",""],["","","TORSEMIDE","20 MG","","Select","Select",""],["","","CARVEDILOL","25 MG","","Select","Select",""],["","","NOVOLIN R FLEXPEN RELION","","","Select","Select",""],["","","EMBECTA PEN NEEDLE\/ULTRA-FINE\/32G X 6MM","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","COMIRNATY 2025-26","3 ML","","Select","Select",""],["","","TWINRIX","","","Select","Select",""],["","","NOVOLIN R FLEXPEN","","","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","","","Select","Select",""],["","","CAPVAXIVE","0.5 ML","","Select","Select",""],["","","NOVOLIN R RELION","","","Select","Select",""],["","","AREXVY","120 MCG","","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":""}]}]}