{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LYDIA M MCGREW","gend":1,"currentgend":"","add":"625 E 13TH ST","city":"EUDORA","state":"KS","zip":"66025","dob":"1935-08-23","age":"","mstatus":"","insh":"K44009450","cliId":"","pno":"7857648573","cno":"","email":"","ename":"","eno":"","pphy":"LAUREN PEREZ","ppno":"7855053636","pcpadd":"1130 W 4TH ST","pcpcity":"LAWRENCE","pcpstate":"KS","pcpzip":"66049","pcpcounty":"","pcpid":"","pcpname":"LMH HEALTH HEART CENTER","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"625 E 13TH ST","madd2":"","madd3":"","mcity":"EUDORA","mstate":"KS","mzip":"66025","pcpfaxno":"","pcpnpi":"1992101935","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44009450","medicareid":"2CQ2K27WW90","medicaidid":"2CQ2K27WW90","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I4720","Z043","M25551","N1830","F0390","J42","I129","E785","E039","W19XXXA","Z66","Z79899","Z950","I10","N179","G309","F3341","K5900","R296","F02B0","Z993","F0283","F0284","I1310","F03B0","I441","Z7982","F32A","R011","I422","E441","I4729","E860","M25562","Z9181","Z6823","Z880","R5381","Z515"],"date":["2025-07-31","2025-07-29","2025-07-30","2026-05-14","2025-07-31","2026-03-03","2025-07-31","2025-07-31","2025-07-31","2025-07-31","2025-07-31","2025-07-31","2025-08-08","2025-07-29","2025-07-29","2026-03-03","2026-05-14","2026-03-03","2026-03-03","2026-05-14","2026-03-03","2026-01-08","2025-10-03","2026-05-14","2025-08-08","2025-04-17","2025-07-30","2025-03-07","2025-03-07","2025-03-07","2025-07-30","2025-07-30","2025-07-30","2025-07-30","2025-07-30","2025-07-30","2025-07-30","2026-05-14","2026-05-14"],"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":[["","","MIRTAZAPINE","15 MG","","Select","Select",""],["","","METOPROLOL SUCCINATE ER","25 MG","","Select","Select",""],["","","LOSARTAN POTASSIUM","50 MG","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","VENLAFAXINE HYDROCHLORIDE ER","150 MG","","Select","Select",""],["","","SYNTHROID","50 MCG","","Select","Select",""],["","","Mirtazapine Tab","15 MG","","Select","Select",""],["","","Losartan Pot Tab","50 MG","","Select","Select",""],["","","Synthroid Tab","50 MCG","","Select","Select",""],["","","Metoprol Suc Tab","50 MG","","Select","Select",""],["","","Venlafaxine Cap","150 MG","","Select","Select",""],["","","Albuterol Aer Hfa","","","Select","Select",""],["","","Atorvastatin Tab","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":""}]}]}