{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHELLE R TOWNLEY","gend":1,"currentgend":"","add":"1002 N Poplar St","city":"Hutchinson","state":"KS","zip":"67501","age":"","mstatus":"","insh":"K44011134","cliId":"","pno":"6208992308","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":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44011134","medicareid":"9QQ5HE0QR83","medicaidid":"9QQ5HE0QR83","pcpFlag":"","dob":"1960-04-19"},{"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":["R413","Z6828","N816","K5730","I708","R4182","R9082","R531","A041","A040","E871","E1165","R000","K5989","G9340","A419","E119","F419","Z79899","Z7984","Z7982","Z87891","R2681","Z6831","R200","R3589","Z6830","Z09","F319","Z1152","E1169","I10","E669","R197","R2689","Z1211","F3181","G3184","Z8616","E1151","Z13820","F411","Z1231","Z780","F330","Z6829","L308","E162","G3109"],"date":["2025-10-28","2025-12-22","2025-09-28","2025-10-09","2025-09-28","2025-10-15","2025-09-28","2025-10-15","2025-10-15","2025-09-30","2025-10-21","2026-03-10","2025-09-28","2025-09-30","2025-09-30","2025-09-30","2025-09-30","2025-08-02","2025-12-02","2025-10-09","2025-10-09","2025-10-09","2025-05-14","2025-05-09","2025-07-14","2025-07-14","2025-09-30","2025-08-06","2026-02-05","2025-08-03","2026-03-10","2025-10-29","2025-09-30","2025-10-06","2025-10-06","2025-10-21","2025-10-21","2026-02-25","2025-10-09","2026-03-10","2025-11-24","2026-04-22","2025-12-02","2026-01-16","2026-06-09","2026-03-10","2026-02-25","2026-03-10","2026-04-22"],"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":[["","","LAMOTRIGINE","25 MG","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","0.10%","","Select","Select",""],["","","HYDROXYZINE HYDROCHLORIDE","25 MG","","Select","Select",""],["","","LISINOPRIL","40 MG","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE ER","500 MG","","Select","Select",""],["","","FLUOXETINE HYDROCHLORIDE","20 MG","","Select","Select",""],["","","JANUVIA","25 MG","","Select","Select",""],["","","HEALTHPRO BLOOD GLUCOSE MONITORING SYSTEM","","","Select","Select",""],["","","RYBELSUS","3 MG","","Select","Select",""],["","","GLIPIZIDE","10 MG","","Select","Select",""],["","","MECLIZINE HYDROCHLORIDE","25 MG","","Select","Select",""],["","","BUSPIRONE HYDROCHLORIDE","7.5 MG","","Select","Select",""],["","","AMOXICILLIN","875 MG","","Select","Select",""],["","","JARDIANCE","10 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","CIPROFLOXACIN HYDROCHLORIDE","500 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","20 MEQ","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE","1000 MG","","Select","Select",""],["","","Rybelsus Tab","3 MG","","Select","Select",""],["","","Meclizine Tab","25 MG","","Select","Select",""],["","","Buspirone Tab","7.5 MG","","Select","Select",""],["","","Lamotrigine Tab","25 MG","","Select","Select",""],["","","Januvia Tab","25 MG","","Select","Select",""],["","","Triamcinolon Cre 0.1%","","","Select","Select",""],["","","Ciprofloxacn Tab","500 MG","","Select","Select",""],["","","Hydroxyz Hcl Tab","25 MG","","Select","Select",""],["","","Triamcinolon Oin 0.1%","","","Select","Select",""],["","","Metformin Tab","500 MG","","Select","Select",""],["","","Pot Chloride Tab","20 MEQ","","Select","Select",""],["","","Jardiance Tab","10 MG","","Select","Select",""],["","","Lisinopril Tab","40 MG","","Select","Select",""],["","","Amoxicillin Tab","875 MG","","Select","Select",""],["","","Azithromycin Tab","250 MG","","Select","Select",""],["","","Glipizide 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":""}]}]}