{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HAROLD G HOLDEN","gend":0,"currentgend":"","add":"4501 SW CRENSHAW DR","city":"TOPEKA","state":"KS","zip":"66610","dob":"1939-10-21","age":"","mstatus":"","insh":"K44000384","cliId":"","pno":"7852711820","cno":"","email":"","ename":"","eno":"","pphy":"MEL SETTER","ppno":"7856502880","pcpadd":"920 SW LANE ST","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"67601","pcpcounty":"","pcpid":"","pcpname":"TOPEKA EAR NOSE & THROAT PA","plan":"BCBSKS","program":"Medicare","lob":"007","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"4501 SOUTHWEST CRENSHAW DRIVE","madd2":"","madd3":"","mcity":"TOPEKA","mstate":"KS","mzip":"66610","pcpfaxno":"","pcpnpi":"1922022581","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44000384","medicareid":"3CH5TW6EE58","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H353111","H35342","Z98890","M5450","E871","H353134","E785","M530","H60392","H8103","S4991XA","W19XXXA","S42101A","H353222","S42291A","Z96611","W010XXA","G8918","S42301D","I4891","M25611","S42201A","D649","I2510","Z8619","Z87891","Z882","Z7982","Z860100","R911","H9193","Z974","Z9842","Z9841","R54","M150","H9190","H8109","K5790","I6529","Z79891","M546","I6521","R55","I6523","Z125","Z0000","E782","L601","M79675","R600","Z471","I480","D329","H7012","H906","L821","L814","D1801","D2371","L570","S299XXA","R110","S0990XA","K4090","R791","R7309","L919","R030","R0609","D0422"],"date":["2024-01-10","2025-02-17","2025-07-31","2026-04-24","2025-05-01","2025-02-17","2024-10-15","2025-12-18","2025-04-22","2024-12-23","2024-10-14","2024-10-14","2024-10-14","2024-10-04","2024-10-22","2025-01-22","2024-10-16","2024-10-16","2024-11-07","2025-05-01","2024-12-23","2024-10-15","2024-10-15","2024-10-30","2024-10-15","2025-05-01","2024-10-15","2024-10-30","2024-10-30","2024-10-15","2024-10-15","2024-10-15","2024-10-15","2024-10-15","2024-10-15","2024-10-30","2024-10-30","2024-10-30","2024-10-30","2024-10-30","2024-10-30","2025-07-09","2025-07-29","2025-07-29","2025-09-18","2025-09-19","2025-09-18","2025-09-18","2025-11-24","2025-11-24","2025-11-24","2025-01-22","2025-06-09","2025-03-17","2026-01-29","2025-04-08","2025-04-29","2025-04-29","2025-04-29","2025-04-29","2025-06-02","2025-05-01","2025-05-01","2025-05-01","2025-05-01","2025-05-01","2025-05-01","2025-04-29","2025-06-09","2025-06-09","2026-05-26"],"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":[["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","CIPROFLOXACIN HYDROCHLORIDE","0.30%","","Select","Select",""],["","","CLOTRIMAZOLE","1%","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","FLUOROURACIL","5%","","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":""}]}]}