{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CURTIS A BRUMBAUGH","gend":0,"currentgend":"","add":"2206 S STILWELL ST","city":"PITTSBURG","state":"KS","zip":"66762","age":"","mstatus":"","insh":"K44011105","cliId":"","pno":"6207041701","cno":"","email":"cabrumbaugh@outlook.com","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"2206 S STILWELL ST","madd2":"","madd3":"","mcity":"PITTSBURG","mstate":"KS","mzip":"66762","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44011105","medicareid":"6E79VG2CR38","medicaidid":"6E79VG2CR38","pcpFlag":"","dob":"1957-07-17"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M47817","M5116","I10","M48062","D500","I129","Z8546","C61","M5416","J0190"],"date":["2026-04-07","2025-11-11","2026-05-20","2026-01-19","2025-05-12","2026-01-19","2026-01-19","2026-01-16","2026-05-20","2026-05-20"],"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":[["","","ESOMEPRAZOLE MAGNESIUM","40 MG","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","CHLORTHALIDONE","25 MG","","Select","Select",""],["","","CANDESARTAN CILEXETIL","16 MG","","Select","Select",""],["","","MONTELUKAST SODIUM","10 MG","","Select","Select",""],["","","FLUTICASONE PROPIONATE\/SALMETEROL","","","Select","Select",""],["","","DILTIAZEM HYDROCHLORIDE ER","300 MG","","Select","Select",""],["","","FLUCONAZOLE","100 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","SPIKEVAX COVID-19 VACCINE\/2025-26","","","Select","Select",""],["","","CEFUROXIME AXETIL","500 MG","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","Paxlovid Tab 300-100","","","Select","Select",""],["","","Esomepra Mag Cap","40 MG","","Select","Select",""],["","","Montelukast Tab","10 MG","","Select","Select",""],["","","Candesartan Tab","16 MG","","Select","Select",""],["","","Diltiazem Cap","300 MG","","Select","Select",""],["","","Fluconazole Tab","100 MG","","Select","Select",""],["","","Gabapentin Cap","300 MG","","Select","Select",""],["","","Chlorthalid Tab","25 MG","","Select","Select",""],["","","Spikevax Inj 2025-26","","","Select","Select",""],["","","Albuterol Aer Hfa","","","Select","Select",""],["","","Flutic\/Salme Inh 232\/14","","","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":""}]}]}