{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARIANNE BARNARD","gend":1,"currentgend":"","add":"5000 CLINTON PKWY","city":"LAWRENCE","state":"KS","zip":"660478939","age":"","mstatus":"","insh":"K44009805","cliId":"","pno":"7086069346","cno":"","email":"tinyseed27@yahoo.com","ename":"","eno":"","pphy":"THOMAS MARCELLINO","ppno":7855055850,"pcpadd":"1112 W 6TH ST","pcpcity":"LAWRENCE","pcpstate":"KS","pcpzip":"66044-1346","pcpcounty":"","pcpid":"","pcpname":"LMH HEALTH PRIMARY CARE - FREE STATE","plan":"BCBSKS","program":"Medicare","lob":"013","region":"","aligned":"","ano":"","add2":"APT 1104","add3":"","madd1":"5000 CLINTON PKWY","madd2":"APT 1104","madd3":"","mcity":"LAWRENCE","mstate":"KS","mzip":"660478939","pcpfaxno":"","pcpnpi":1134109663,"currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44009805","medicareid":"4A38CA8XV20","medicaidid":"4A38CA8XV20","pcpFlag":"","dob":"1946-03-31"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M542","M9902","M9903","S3991XA","Z7689","R300","R634","R1030","H04123","H52223","R61","K5900","K5909","E785","F320","M8580","R350","R109","E559","I6523","Z780","M8588"],"date":["2026-06-11","2026-06-11","2026-06-11","2025-07-03","2026-03-04","2025-07-03","2025-07-03","2025-11-13","2026-06-05","2026-06-05","2025-07-03","2025-07-03","2025-11-13","2026-02-27","2026-02-27","2026-03-04","2026-02-27","2026-03-04","2026-03-04","2026-03-12","2026-04-21","2026-04-21"],"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":[]},{"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":""}]}]}