{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CINDY L CONSTANTINO","gend":1,"currentgend":"","add":"7112 SW 19TH LN","city":"TOPEKA","state":"KS","zip":"66615","age":"","mstatus":"","insh":"K44009687","cliId":"","pno":"7852306780","cno":"","email":"cindyconstantino46@gmail.com","ename":"","eno":"","pphy":"BRYON BIGHAM","ppno":"7857422131","pcpadd":"901 SW GARFIELD AVE","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66434-2314","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"7112 SW 19TH LN","madd2":"","madd3":"","mcity":"TOPEKA","mstate":"KS","mzip":"66615","pcpfaxno":"","pcpnpi":"1518053594","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44009687","medicareid":"4GY6RW5HM77","medicaidid":"","pcpFlag":"","dob":"1946-10-29"},{"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":["M5442","G8929","K838","K8020","M47816","L578","L710","L738","D229","L814","L821","R238","E6601","M4316","R7303","Z981","M519","M48061","G250","M488X6","R42","Z7722","N952","E119","E782","E8352","Z0000","E66812","R0981","H01024","I10","D171","L918","K760","Z6837","J4520","K219","G4733","E88810","M4686","E8889","E785","H547","Z6835"],"date":["2025-08-13","2025-08-13","2025-10-02","2025-10-06","2025-10-10","2025-09-17","2025-09-17","2025-09-17","2025-09-17","2025-09-17","2025-09-17","2025-09-17","2025-10-06","2025-10-06","2025-10-06","2025-11-07","2025-11-10","2025-11-10","2026-02-26","2025-11-07","2026-02-26","2025-12-09","2025-01-23","2026-06-04","2025-02-25","2025-02-25","2025-02-24","2026-06-04","2025-02-24","2025-02-24","2026-06-04","2025-02-24","2025-02-24","2026-05-01","2025-02-24","2026-05-13","2026-06-04","2026-06-04","2026-03-05","2026-02-26","2026-02-26","2026-02-26","2026-02-26","2026-02-26"],"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":[["","","FLUTICASONE PROPIONATE","50 MCG","","Select","Select",""],["","","IMIQUIMOD","5%","","Select","Select",""],["","","METOPROLOL TARTRATE","100 MG","","Select","Select",""],["","","SIMVASTATIN","40 MG","","Select","Select",""],["","","METRONIDAZOLE","0.75%","","Select","Select",""],["","","ESTRADIOL","0.01%","","Select","Select",""],["","","CANDESARTAN CILEXETIL","32 MG","","Select","Select",""],["","","CHLORTHALIDONE","25 MG","","Select","Select",""],["","","DULOXETINE HYDROCHLORIDE DR","30 MG","","Select","Select",""],["","","PROPRANOLOL HYDROCHLORIDE ER","60 MG","","Select","Select",""],["","","BUPROPION HYDROCHLORIDE ER (XL)","150 MG","","Select","Select",""],["","","TOPIRAMATE","25 MG","","Select","Select",""],["","","ERYTHROMYCIN","5 MG","","Select","Select",""],["","","FLUOROURACIL","5%","","Select","Select",""],["","","CIPROFLOXACIN HYDROCHLORIDE","500 MG","","Select","Select",""],["","","AMLODIPINE BESYLATE","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":""}]}]}