{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WAYNE A RADFORD","gend":0,"currentgend":"","add":"1264 SW PLASS AVE","city":"TOPEKA","state":"KS","zip":"66604","dob":"1949-07-18","age":"","mstatus":"","insh":"K44000362","cliId":"","pno":"7852158898","cno":"","email":"gmc72@cox.net","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"001","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1679371710","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44000362","medicareid":"9MJ3N69DE89","medicaidid":"9MJ3N69DE89","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H353221","I480","G8929","Z95818","Z98890","Z8679","R944","R7309","K5730","N1831","N401","L821","L814","Z872","K5909","Z86010","I4891","Z01810","E782","N410","M79645","D72829","Z4789","E7800","I950","L738","H353111","H35371","H3562","Z961","R7989","R194","D123","K648","D125","L578","K635","H1013","H04123","H43813","N411","N529","Z1339","Z1331","K2270","K7689","M65311","R918","R351","Z131","M1812","Z888","E0590","K219","N189","F419","R09A2","R1319","E0500","R079","H353222","I493","R110","E042","Z8639","R6882","K5900","L608","M62838","K317","K2950","D229","L820","R238","L739","R5383","Z0000","Q248","G4709","R634","G629","R008","I440","N5202","L719","Z01818","R300","N50812","R000","R791","R0789","R1084","E785","Z7982","E039","M65312","E049","Z79899","R195","E0520","R1011","Z9049","R29818","F4310","M7989","T148XXA"],"date":["2025-04-30","2026-05-22","2024-06-11","2026-05-22","2026-03-21","2026-05-22","2025-05-06","2024-06-29","2024-03-26","2026-05-20","2025-10-07","2026-05-26","2026-05-26","2024-04-24","2024-05-15","2024-05-15","2026-02-22","2024-06-17","2025-12-03","2024-06-11","2024-06-11","2024-06-29","2024-06-29","2024-06-17","2024-06-05","2026-05-26","2026-03-18","2026-03-18","2026-03-18","2026-03-18","2025-12-31","2024-08-06","2024-08-06","2024-08-06","2024-08-06","2026-05-26","2024-08-06","2024-09-20","2025-04-30","2026-03-18","2025-09-16","2025-03-07","2025-12-12","2025-12-12","2025-12-12","2024-12-12","2024-12-12","2025-05-06","2025-10-07","2024-12-16","2024-06-17","2025-12-03","2026-01-22","2025-12-03","2025-07-15","2025-03-07","2025-03-07","2025-03-07","2026-05-20","2025-07-03","2025-07-02","2026-01-18","2025-09-12","2025-11-26","2025-10-07","2026-02-18","2025-10-09","2025-08-12","2025-10-03","2025-10-30","2025-10-30","2026-05-26","2025-11-25","2025-11-25","2026-05-26","2025-12-31","2025-12-12","2025-12-12","2025-12-12","2025-12-12","2025-12-31","2025-12-03","2025-12-03","2025-09-16","2025-02-21","2025-02-27","2025-04-30","2025-04-30","2025-05-06","2026-02-22","2025-05-16","2025-05-16","2025-10-30","2025-07-15","2025-10-30","2025-02-27","2025-02-27","2025-02-27","2026-01-22","2026-01-21","2026-02-22","2026-02-22","2026-03-12","2026-03-12","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":[["","","ATORVASTATIN CALCIUM","40 MG","","Select","Select",""],["","","CIPROFLOXACIN HYDROCHLORIDE","500 MG","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40 MG","","Select","Select",""],["","","TRAZODONE HYDROCHLORIDE","100 MG","","Select","Select",""],["","","CARVEDILOL","3.125 MG","","Select","Select",""],["","","NEOMYCIN\/POLYMYXIN\/DEXAMETHASONE","0.10%","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","METHIMAZOLE","5 MG","","Select","Select",""],["","","ESOMEPRAZOLE MAGNESIUM","40 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","DILTIAZEM HYDROCHLORIDE ER","120 MG","","Select","Select",""],["","","ONDANSETRON ODT","4 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","FAMOTIDINE","20 MG","","Select","Select",""],["","","PRAZOSIN HYDROCHLORIDE","1 MG","","Select","Select",""],["","","Ciprofloxacn Tab","500 MG","","Select","Select",""],["","","Doxycycl Hyc Tab","100 MG","","Select","Select",""],["","","Diltiazem Cap","120 MG","","Select","Select",""],["","","Hydroco\/Apap Tab 5-325Mg","","","Select","Select",""],["","","Gabapentin Cap","300 MG","","Select","Select",""],["","","Trazodone Tab","100 MG","","Select","Select",""],["","","Amoxicillin Tab","500 MG","","Select","Select",""],["","","Methimazole Tab","5 MG","","Select","Select",""],["","","Ondansetron Tab","4 MG","","Select","Select",""],["","","Neo\/Poly\/Dex Sus 0.1% Op","","","Select","Select",""],["","","Carvedilol Tab","3.125 MG","","Select","Select",""],["","","Famotidine Tab","20 MG","","Select","Select",""],["","","Esomepra Mag Cap","40 MG","","Select","Select",""],["","","Pantoprazole Tab","40 MG","","Select","Select",""],["","","Atorvastatin Tab","40 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":""}]}]}