{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRYAN D WHITAKER","gend":0,"currentgend":"","add":"1610 S LIMUEL ST","city":"WICHITA","state":"KS","zip":"67235","dob":"1982-02-08","age":"","mstatus":"","insh":"2X42F54UD05","cliId":"","pno":"3167689979","cno":"","email":"bryanw597@gmail.com","ename":"","eno":"","pphy":"LINDSEY MCCALL","ppno":"3162604110","pcpadd":"3343 W CENTRAL AVE","pcpcity":"WICHITA","pcpstate":"KS","pcpzip":"67203-4917","pcpcounty":"","pcpid":"","pcpname":"HERMES HEALTHCARE","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1610 S LIMUEL ST","madd2":"","madd3":"","mcity":"WICHITA","mstate":"KS","mzip":"67235","pcpfaxno":"","pcpnpi":1811776057,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2X42F54UD05","medicaidid":"2X42F54UD05","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":[]},{"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":[["","","Comirnaty Inj 2024-25","","","Select","Select",""],["","","Albuterol Neb 0.083%","","","Select","Select",""],["","","Amphet\/Dextr Tab","30 MG","","Select","Select",""],["","","Oxycod\/Apap Tab 10-325Mg","","","Select","Select",""],["","","Fluticasone Spr","50 MCG","","Select","Select",""],["","","Tobramycin Neb","300\/5 ML","","Select","Select",""],["","","Flutic\/Salme Aer 230-21","","","Select","Select",""],["","","Incruse Elpt Inh","62.5 MCG","","Select","Select",""],["","","Escitalopram Tab","10 MG","","Select","Select",""],["","","Levofloxacin Tab","750 MG","","Select","Select",""],["","","Aripiprazole Tab","2 MG","","Select","Select",""],["","","Flutic\/Salme Aer 250\/50","","","Select","Select",""],["","","Symbicort Aer 160-4.5","","","Select","Select",""],["","","Azelastine Spr 0.1%","","","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":""}]}]}