{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHARON K ANTHONY","gend":1,"currentgend":"","add":"1525 Foxfire Dr","city":"Lawrence","state":"KS","zip":"66047","age":"","mstatus":"","insh":"K44009829","cliId":"","pno":"7857669749","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":"1525 Foxfire Dr","madd2":"","madd3":"","mcity":"Lawrence","mstate":"KS","mzip":"66047","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44009829","medicareid":"6TP6CW5YT83","medicaidid":"6TP6CW5YT83","pcpFlag":"","dob":"1960-02-13"},{"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":["E119","H04123","H52223","N184","Z7984","N200","I10","E039","E785","H5212","Z961","R899","H2513","B9789","E1122","Z0130","Z7189","E1165"],"date":["2025-07-23","2025-07-23","2025-10-14","2026-06-17","2026-06-17","2026-06-08","2026-06-17","2026-06-17","2026-06-17","2025-10-14","2025-10-14","2025-08-18","2025-03-14","2025-05-16","2026-01-15","2026-05-27","2026-05-27","2026-06-08"],"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",""],["","","LEVOTHYROXINE SODIUM","75 MCG","","Select","Select",""],["","","CICLOPIROX NAIL LACQUER","8%","","Select","Select",""],["","","GLIPIZIDE","5 MG","","Select","Select",""],["","","ESCITALOPRAM OXALATE","5 MG","","Select","Select",""],["","","SIMVASTATIN","5 MG","","Select","Select",""],["","","BUSPIRONE HYDROCHLORIDE","10 MG","","Select","Select",""],["","","TRAZODONE HYDROCHLORIDE","50 MG","","Select","Select",""],["","","JANUVIA","25 MG","","Select","Select",""],["","","JARDIANCE","10 MG","","Select","Select",""],["","","KERENDIA","10 MG","","Select","Select",""],["","","PREDNISOLONE ACETATE","1%","","Select","Select",""],["","","NEOMYCIN\/POLYMYXIN\/DEXAMETHASONE","0.10%","","Select","Select",""],["","","FLUBLOK 2025-2026","","","Select","Select",""],["","","COMIRNATY 2025-26","3 ML","","Select","Select",""],["","","GVOKE HYPOPEN 2-PACK","1\/0.2 ML","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","Comirnaty Inj 30\/.3Ml","","","Select","Select",""],["","","Januvia Tab","25 MG","","Select","Select",""],["","","Flublok Inj 2025-26","","","Select","Select",""],["","","Escitalopram Tab","5 MG","","Select","Select",""],["","","Simvastatin Tab","5 MG","","Select","Select",""],["","","Ciclopirox Sol 8%","","","Select","Select",""],["","","Kerendia Tab","10 MG","","Select","Select",""],["","","Neo\/Poly\/Dex Sus 0.1% Op","","","Select","Select",""],["","","Dexcom G7 Mis Sensor","","","Select","Select",""],["","","Jardiance Tab","10 MG","","Select","Select",""],["","","Mounjaro Inj 2.5\/0.5","","","Select","Select",""],["","","Glipizide Tab","5 MG","","Select","Select",""],["","","Gvoke Hypo 2 Inj","1\/0.2 ML","","Select","Select",""],["","","Trazodone Tab","50 MG","","Select","Select",""],["","","Levothyroxin Tab","75 MCG","","Select","Select",""],["","","Buspirone Tab","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":""}]}]}