{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID H MCENTIRE","gend":0,"currentgend":"","add":"2600 SW 35TH TER","city":"TOPEKA","state":"KS","zip":"666111831","dob":"1949-09-15","age":"","mstatus":"","insh":"K44000471","cliId":"","pno":"7852665345","cno":"7852304366","email":"DAVID.MCENTIRE@COX.NET","ename":"","eno":"","pphy":"R ILIFF","ppno":"7852716161","pcpadd":"1119 SW GAGE BLVD","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66604-1774","pcpcounty":"","pcpid":"","pcpname":"R DOUGLAS ILIFF MD PA","plan":"BCBSKS","program":"Medicare","lob":"001","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1184692386","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44000471","medicareid":"3N86VQ3HW44","medicaidid":"3N86VQ3HW44","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z8546","Z87442","H9313","Z1331","E785","I10","Z8672","R102","M5136","M47816","R1032","M25552","G8929","M25551","M25511","R053","Z125","K4090","I459","D176","M7918","J302","F639","Z86718","N329","Z8551","Z86711","Z7901","M79604","M25512","M5450","M48061","Z98890","Z8719","I4710","Z880","M5416","L918","J321","J3489","M542","H903","H9203","M51369"],"date":["2025-11-06","2026-01-12","2024-05-08","2025-11-06","2025-11-06","2025-11-06","2024-06-11","2025-05-05","2024-06-13","2025-11-17","2024-06-13","2026-04-02","2024-11-15","2026-04-02","2025-02-04","2026-03-05","2024-06-05","2025-06-18","2025-06-18","2025-06-18","2025-11-14","2025-11-06","2025-11-06","2025-11-06","2025-03-13","2025-06-18","2025-06-18","2025-06-18","2025-04-09","2025-05-05","2025-05-28","2025-05-28","2025-06-06","2025-06-06","2025-06-18","2025-06-18","2026-04-27","2026-03-05","2026-04-03","2026-04-03","2026-04-03","2026-04-03","2026-04-03","2026-04-27"],"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":[["","","AMLODIPINE BESYLATE","2.5 MG","","Select","Select",""],["","","TRAMADOL HYDROCHLORIDE","50 MG","","Select","Select",""],["","","MELOXICAM","15 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","BOOSTRIX","","","Select","Select",""],["","","Tramadol Hcl Tab","50 MG","","Select","Select",""],["","","Hydroco\/Apap Tab 5-325Mg","","","Select","Select",""],["","","Boostrix Inj","","","Select","Select",""],["","","Amlodipine Tab","2.5 MG","","Select","Select",""],["","","Meloxicam Tab","15 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":""}]}]}