{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RAND L HUGHES","gend":0,"currentgend":"","add":"3511 MORNING DOVE CIR","city":"LAWRENCE","state":"KS","zip":"66049","age":"","mstatus":"","insh":"K44010896","cliId":"","pno":"9133293897","cno":"","email":"","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 - WEST CAMPUS","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"3511 MORNING DOVE CIR","madd2":"","madd3":"","mcity":"LAWRENCE","mstate":"KS","mzip":"66049","pcpfaxno":"","pcpnpi":"1134109663","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44010896","medicareid":"5NJ5R97TQ80","medicaidid":"5NJ5R97TQ80","pcpFlag":"","dob":"1950-02-17"},{"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":["M546","Z7689","F329","F902","M62830","G4700","E119","M47816","M5450","F411","F325","F429","M419","M4316","Z136"],"date":["2026-06-04","2025-07-01","2026-05-13","2026-05-13","2025-02-10","2025-02-10","2025-03-19","2025-03-19","2025-03-19","2025-03-19","2025-03-19","2025-03-19","2025-03-19","2025-03-19","2025-03-19"],"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":[["","","TRAZODONE HYDROCHLORIDE","100 MG","","Select","Select",""],["","","CLONAZEPAM","0.5 MG","","Select","Select",""],["","","GABAPENTIN","100 MG","","Select","Select",""],["","","ALPRAZOLAM","0.5 MG","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE","500 MG","","Select","Select",""],["","","TIZANIDINE HYDROCHLORIDE","2 MG","","Select","Select",""],["","","AMPHETAMINE\/DEXTROAMPHETAMINE","10 MG","","Select","Select",""],["","","DICLOFENAC SODIUM DR","75 MG","","Select","Select",""],["","","TRIAZOLAM","0.25 MG","","Select","Select",""],["","","ZOLPIDEM TARTRATE ER","12.5 MG","","Select","Select",""],["","","Zolpidem Er Tab","12.5 MG","","Select","Select",""],["","","Clonazepam Tab","0.5 MG","","Select","Select",""],["","","Alprazolam Tab","0.5 MG","","Select","Select",""],["","","Trazodone Tab","100 MG","","Select","Select",""],["","","Diclofenac Tab","75 MG","","Select","Select",""],["","","Triazolam Tab","0.25 MG","","Select","Select",""],["","","Metformin Tab","500 MG","","Select","Select",""],["","","Gabapentin Cap","300 MG","","Select","Select",""],["","","Tizanidine Tab","2 MG","","Select","Select",""],["","","Amphet\/Dextr 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":""}]}]}