{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBORAH L ALBRIGHT","gend":1,"currentgend":"","add":"9413 110th Rd","city":"Mayetta","state":"KS","zip":"66509","dob":"1957-11-18","age":"","mstatus":"","insh":"K44010554","cliId":"","pno":"7859866910","cno":"","email":"deborahalbright0@gmail.com","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"LAWRENCE SPINE CENTER","plan":"BCBSKS","program":"Medicare","lob":"001","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1588378178","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44010554","medicareid":"3A44NM8UV79","medicaidid":"3A44NM8UV79","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M4712","M9961","E119","R9431","M5412","E669","E039","I10","G4700","Z6831","R1310","Z794","Z831","Z7984","M2578","M4722","E1140","A084","E860","R112","R197","R509","U071","Z7689","G629","R490","M7918","Z981","Z98890","M5030","M542","M25511","J3801","M4802","Z85828","M4312","M50122","M50123","G8929","K760","D72829","M7541","Z7985","Z79899","N3941","N3010","G4710","R0683","R5382","I959","T402X5A","Z880","Z9049","M4322","Z4789","R1319","F419","E8720","R519","K529","R82998","M47812","E559","N12","N10","Z8719","M25611","R10A3","Z87442","R350","R3129","R351","N3289","R338","Z780","B3749","R10A0","R109","I350","R001","E1165","N200","M7500","E785","J3800","B957","R300","R319","B49","Z8619"],"date":["2025-06-13","2025-06-13","2026-05-09","2025-06-23","2025-07-17","2025-07-17","2026-03-09","2026-03-19","2025-07-17","2025-07-17","2026-01-19","2026-03-19","2025-06-16","2026-04-30","2025-06-13","2025-07-17","2025-12-11","2025-08-29","2025-09-22","2025-08-29","2025-09-19","2025-08-29","2025-09-19","2026-02-04","2025-09-15","2026-02-04","2025-12-15","2026-02-04","2026-02-04","2025-12-10","2026-02-04","2026-02-04","2026-02-04","2025-09-26","2025-02-03","2025-04-15","2025-04-15","2025-04-15","2026-01-27","2026-03-19","2025-04-29","2025-04-29","2025-04-29","2026-03-09","2026-04-24","2026-05-08","2025-05-17","2025-05-29","2025-05-17","2025-06-13","2025-06-13","2025-06-13","2025-07-17","2025-06-27","2025-12-15","2025-06-30","2026-03-19","2025-09-22","2025-09-19","2025-09-19","2026-03-09","2025-04-15","2025-06-09","2025-04-26","2025-05-05","2025-05-29","2026-02-04","2026-03-02","2026-03-02","2026-03-30","2026-03-17","2026-03-30","2026-03-30","2026-03-09","2026-05-08","2026-05-08","2026-05-05","2026-05-05","2026-03-19","2026-03-19","2026-03-19","2026-03-19","2026-03-19","2026-01-27","2026-01-27","2026-02-23","2026-04-30","2026-04-30","2026-04-30","2026-04-30"],"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":[["","","ZOLPIDEM TARTRATE","10 MG","","Select","Select",""],["","","CONTOUR NEXT BLOOD GLUCOSE TEST","","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","SOLIFENACIN SUCCINATE","5 MG","","Select","Select",""],["","","TAMSULOSIN HYDROCHLORIDE","0.4 MG","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","100 MCG","","Select","Select",""],["","","TIZANIDINE HYDROCHLORIDE","4 MG","","Select","Select",""],["","","NITROFURANTOIN MONOHYDRATE\/MACROCRYSTALS","100 MG","","Select","Select",""],["","","TOUJEO MAX SOLOSTAR","","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","NOVOLOG FLEXPEN RELION","","","Select","Select",""],["","","LISINOPRIL","5 MG","","Select","Select",""],["","","FLUCONAZOLE","100 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","TRAMADOL HYDROCHLORIDE","50 MG","","Select","Select",""],["","","MYRBETRIQ","50 MG","","Select","Select",""],["","","AMITRIPTYLINE HYDROCHLORIDE","50 MG","","Select","Select",""],["","","CIPROFLOXACIN HYDROCHLORIDE","500 MG","","Select","Select",""],["","","CEFEPIME","2 GM","","Select","Select",""],["","","MICAFUNGIN","100 MG","","Select","Select",""],["","","ESTRADIOL","0.01%","","Select","Select",""],["","","OXYCODONE HYDROCHLORIDE","5 MG","","Select","Select",""],["","","JARDIANCE","25 MG","","Select","Select",""],["","","MICROLET LANCETS","","","Select","Select",""],["","","CONTOUR NEXT GEN BLOOD GLUCOSE MONITORING SYSTEM","","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40 MG","","Select","Select",""],["","","METRONIDAZOLE","250 MG","","Select","Select",""],["","","METHOCARBAMOL","750 MG","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","5 MG","","Select","Select",""],["","","ONDANSETRON ODT","4 MG","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","CLONAZEPAM","0.5 MG","","Select","Select",""],["","","LEVOFLOXACIN","500 MG","","Select","Select",""],["","","FLUOROURACIL","5%","","Select","Select",""],["","","MUPIROCIN","2%","","Select","Select",""],["","","ONETOUCH VERIO TEST STRIPS","","","Select","Select",""],["","","Paxlovid Tab 300-100","","","Select","Select",""],["","","Solifenacin Tab","5 MG","","Select","Select",""],["","","Levothyroxin Tab","88 MCG","","Select","Select",""],["","","Clonazepam Tab","0.5 MG","","Select","Select",""],["","","Microlet Mis Lancets","","","Select","Select",""],["","","Estradiol Cre 0.01%","","","Select","Select",""],["","","Ciprofloxacn Tab","500 MG","","Select","Select",""],["","","Jardiance Tab","25 MG","","Select","Select",""],["","","Metronidazol Tab","250 MG","","Select","Select",""],["","","Cyclobenzapr Tab","5 MG","","Select","Select",""],["","","Fluorouracil Cre 5%","","","Select","Select",""],["","","Onetouch Tes Verio","","","Select","Select",""],["","","Mupirocin Oin 2%","","","Select","Select",""],["","","Contour Tes Next","","","Select","Select",""],["","","Tramadol Hcl Tab","50 MG","","Select","Select",""],["","","Ondansetron Tab","4 MG","","Select","Select",""],["","","Novolog Inj Flex Rel","","","Select","Select",""],["","","Novolog Inj Flexpen","","","Select","Select",""],["","","Levofloxacin Tab","750 MG","","Select","Select",""],["","","Fluconazole Tab","100 MG","","Select","Select",""],["","","Gabapentin Cap","300 MG","","Select","Select",""],["","","Methocarbam Tab","750 MG","","Select","Select",""],["","","Oxycodone Tab","5 MG","","Select","Select",""],["","","Toujeo Max Inj 300\/Ml","","","Select","Select",""],["","","Pantoprazole Tab","40 MG","","Select","Select",""],["","","Tamsulosin Cap","0.4 MG","","Select","Select",""],["","","Nitrofurantn Cap","100 MG","","Select","Select",""],["","","Contour Next Kit Gen","","","Select","Select",""],["","","Azithromycin Tab","250 MG","","Select","Select",""],["","","Zolpidem 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":""}]}]}