{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DARWIN L BRUNER","gend":0,"currentgend":"","add":"1859 12000 RD","city":"OSWEGO","state":"KS","zip":"67356","age":"","mstatus":"","insh":"K44010967","cliId":"","pno":"6207786864","cno":"","email":"darwinbruner@gmail.com","ename":"","eno":"","pphy":"SCOTT FOX","ppno":"6208205800","pcpadd":"1133 SW TOPEKA BLVD","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"67357-4948","pcpcounty":"","pcpid":"","pcpname":"LCMC PHYSICIANS GROUP","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1859 12000 RD","madd2":"","madd3":"","mcity":"OSWEGO","mstate":"KS","mzip":"67356","pcpfaxno":"","pcpnpi":"1396977815","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44010967","medicareid":"8RT9JY4ER46","medicaidid":"8RT9JY4ER46","pcpFlag":"","dob":"1941-11-27"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","E039","H26112","I480","E782","I358","I340","Z7901","R9431","R9439","Z125","R9720","R339","H2511","K5730","K449","N138","R935","N401","C61"],"date":["2026-06-09","2026-06-09","2026-06-15","2025-11-12","2026-06-09","2025-03-14","2025-11-12","2025-11-12","2025-09-05","2025-11-12","2026-06-09","2026-06-09","2026-06-09","2026-06-15","2025-12-26","2025-12-26","2026-03-23","2026-03-23","2026-03-16","2026-03-23"],"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":[["","","LATANOPROST","0.01%","","Select","Select",""],["","","DORZOLAMIDE HCL\/TIMOLOL MALEATE","","","Select","Select",""],["","","GLIMEPIRIDE","2 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE ER","500 MG","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","75 MCG","","Select","Select",""],["","","ELIQUIS","2.5 MG","","Select","Select",""],["","","LISINOPRIL","20 MG","","Select","Select",""],["","","CONTOUR NEXT BLOOD GLUCOSE TEST","","","Select","Select",""],["","","CONTOUR NEXT GEN BLOOD GLUCOSE MONITORING SYSTEM","","","Select","Select",""],["","","CIPROFLOXACIN HYDROCHLORIDE","500 MG","","Select","Select",""],["","","Ciprofloxacn Tab","500 MG","","Select","Select",""],["","","Eliquis Tab","2.5 MG","","Select","Select",""],["","","Latanoprost Sol 0.005%","","","Select","Select",""],["","","Metformin Tab","500 MG","","Select","Select",""],["","","Contour Tes Next","","","Select","Select",""],["","","Lisinopril Tab","20 MG","","Select","Select",""],["","","Glimepiride Tab","2 MG","","Select","Select",""],["","","Dorzol\/Timol Sol 2-0.5%Op","","","Select","Select",""],["","","Levothyroxin Tab","75 MCG","","Select","Select",""],["","","Contour Next Kit Gen","","","Select","Select",""],["","","Atorvastatin Tab","20 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":""}]}]}