{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMES E KRUEGER","gend":0,"currentgend":"","add":"1402 LUTHER ST","city":"EMPORIA","state":"KS","zip":"66801","dob":"1936-10-11","age":"","mstatus":"","insh":"K44009815","cliId":"","pno":"6207576670","cno":"","email":"","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"2300 INDUSTRIAL RD","madd2":"APT 319","madd3":"","mcity":"EMPORIA","mstate":"KS","mzip":"668016635","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44009815","medicareid":"3MV3X34MP16","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M85862","B351","E1159","R262","L570","L821","D239","M1732","Z794","R519","M170","G3184","G4733","E785","E119","I110","I5032","E039","R3581","H1013","H3530","M150","N401","N138","E538","M4802","Z860100","Z85828","Z87891","Z556","Z7982","Z7984","H9313","H903","Z9181","Z7902","R2681","Z789","Z23","E1142","L814","R918","R634","R630","R531","F02A11","E860","E876","R627","R42","G450","E1165","I10","L89611","L89621","Z79899","N179","Z9189","Z6822","R638","Z09","Z515","G309","F02811","R1310","K219","E1100"],"date":["2025-07-09","2026-01-15","2025-10-30","2026-01-15","2026-02-19","2026-02-19","2026-02-19","2025-07-10","2026-03-20","2025-07-10","2025-08-20","2026-04-02","2026-03-20","2026-04-22","2025-12-18","2026-03-20","2026-04-22","2026-04-22","2025-10-31","2025-10-31","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2026-04-22","2025-03-26","2025-05-19","2026-01-15","2026-02-19","2026-03-13","2026-06-04","2026-04-20","2026-04-22","2026-01-23","2026-04-02","2026-04-22","2026-04-22","2026-04-22","2026-04-22","2026-04-22","2026-04-22","2026-03-20","2026-03-20","2026-04-20","2026-03-20","2026-04-22","2026-04-22","2026-04-16","2026-04-16","2026-06-04","2026-04-22","2026-04-22","2026-04-22","2026-04-22","2026-04-22"],"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":[["","","METFORMIN HYDROCHLORIDE","500 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","20 MEQ","","Select","Select",""],["","","CONTOUR NEXT BLOOD GLUCOSE TEST","","","Select","Select",""],["","","OMEPRAZOLE","20 MG","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","100 MCG","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE ER","500 MG","","Select","Select",""],["","","CLOPIDOGREL","75 MG","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","SERTRALINE HYDROCHLORIDE","25 MG","","Select","Select",""],["","","TRUEPLUS LANCETS 28G","28 G","","Select","Select",""],["","","EMBECTA PEN NEEDLE\/ULTRA-FINE\/31G X 5MM","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","CONTOUR NEXT GEN BLOOD GLUCOSE MONITORING SYSTEM","","","Select","Select",""],["","","NEOMYCIN\/POLYMYXIN\/DEXAMETHASONE","0.10%","","Select","Select",""],["","","MICROLET NEXT","","","Select","Select",""],["","","MICROLET LANCETS","","","Select","Select",""],["","","JARDIANCE","10 MG","","Select","Select",""],["","","TRUE METRIX BLOOD GLUCOSETEST STRIPS","","","Select","Select",""],["","","COMIRNATY 2025-26","3 ML","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","0.05%","","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":""}]}]}