{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRENDA S JARBOE","gend":1,"currentgend":"","add":"75 SW Pepper Tree Ln","city":"Topeka","state":"KS","zip":"66611","age":"","mstatus":"","insh":"K44011207","cliId":"","pno":"7856400922","cno":"7856400922","email":"","ename":"","eno":"","pphy":"MAGGIE SMITH","ppno":"7856549591","pcpadd":"901 SW GARFIELD AVE","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66606-1670","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1710326715","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44011207","medicareid":"8MP1U91PY38","medicaidid":"8MP1U91PY38","pcpFlag":"","dob":"1952-05-30"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D2372","Z85820","Z1283","Z85828","Z808","D2361","R92323","Z79899","E8940","Z90722","Z13820","R7303","D2239","D225","D2272","D2261","L814","L570","J310","J342","J343","G4719","M19041","M19042","E781","R040","G629","I10","E66813","Z6841","G608","M8589","K219","E66812","I499","R0602","Z6836","G4733","E119","N1831","M0609","R079","R531","R42","R944","R946","D72829","Z7901","M150","M79671","G549","R200","G8929","M79672","I3139","I083","I517","I4891","I129","E1122","Z09","I4719","E870","N200","I493","K5730","I4819","I454","E669","E278","D892","D472","I700","E6601","J45909","I4710","E782","K589","Z96653","Z604","Z7985","Z881","I4892","I447","N182","M0689","M5416","Z635"],"date":["2025-09-12","2026-06-08","2025-09-12","2025-09-12","2025-09-12","2025-06-06","2025-07-18","2026-01-31","2025-07-18","2025-07-18","2025-07-18","2025-07-31","2025-09-12","2025-09-12","2025-09-12","2025-09-12","2025-09-12","2025-09-12","2025-09-10","2025-08-20","2025-08-20","2025-09-04","2025-09-15","2025-09-15","2026-02-02","2025-08-14","2026-05-26","2026-03-09","2025-08-14","2025-08-14","2025-08-21","2025-09-10","2026-06-08","2026-01-30","2026-01-30","2026-03-09","2026-01-31","2026-06-08","2026-01-30","2026-02-11","2026-05-26","2026-01-30","2026-01-30","2026-01-30","2026-01-30","2026-01-30","2026-02-24","2026-06-08","2026-02-03","2026-02-03","2026-05-26","2026-05-26","2026-02-03","2026-02-03","2026-02-02","2026-02-02","2026-01-30","2026-02-06","2026-06-08","2026-06-08","2026-02-11","2026-02-02","2026-02-02","2026-02-24","2026-03-09","2026-03-25","2026-03-23","2026-03-23","2026-03-23","2026-04-01","2026-05-26","2026-05-26","2026-06-08","2026-01-31","2026-06-08","2026-01-31","2026-01-31","2026-01-31","2026-01-31","2026-01-31","2026-06-08","2026-01-31","2026-06-08","2026-06-08","2026-06-08","2026-06-08","2026-06-08","2026-06-08"],"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":[["","","TRAMADOL HYDROCHLORIDE","50 MG","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","FENOFIBRATE","145 MG","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","ENBREL SURECLICK","50 MG","","Select","Select",""],["","","CARVEDILOL","25 MG","","Select","Select",""],["","","LOSARTAN POTASSIUM","50 MG","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","ELIQUIS","5 MG","","Select","Select",""],["","","OMEPRAZOLE DR","20 MG","","Select","Select",""],["","","AMLODIPINE BESYLATE","10 MG","","Select","Select",""],["","","DULOXETINE HYDROCHLORIDE DR","30 MG","","Select","Select",""],["","","MUPIROCIN","2%","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","20 MEQ","","Select","Select",""],["","","Gabapentin Cap","400 MG","","Select","Select",""],["","","Enbrel Srclk Inj","50 MG","","Select","Select",""],["","","Carvedilol Tab","25 MG","","Select","Select",""],["","","Losartan Pot Tab","50 MG","","Select","Select",""],["","","Pot Chloride Tab","20 MEQ","","Select","Select",""],["","","Mupirocin Oin 2%","","","Select","Select",""],["","","Tramadol Hcl Tab","50 MG","","Select","Select",""],["","","Mounjaro Inj 2.5\/0.5","","","Select","Select",""],["","","Albuterol Aer Hfa","","","Select","Select",""],["","","Amlodipine Tab","10 MG","","Select","Select",""],["","","Fenofibrate Tab","145 MG","","Select","Select",""],["","","Eliquis Tab","5 MG","","Select","Select",""],["","","Omeprazole Cap","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":""}]}]}