{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TIMOTHY M REYNOLDS JR","gend":0,"currentgend":"","add":"1308 N Terrance Drive","city":"Wichita","state":"KS","zip":"67208","dob":"1985-09-14","age":"","mstatus":"","insh":"K44001679","cliId":"","pno":"3168694339","cno":"","email":"timothyreynoldsjr@gmail.com","ename":"","eno":"","pphy":"YUHONG KAHNERT","ppno":"3166899111","pcpadd":"3311 E MURDOCK ST","pcpcity":"WICHITA","pcpstate":"KS","pcpzip":"37208-3079","pcpcounty":"","pcpid":"","pcpname":"ASCENSION MEDICAL GROUP VIA CHRISTI PA","plan":"BCBSKS","program":"Medicare","lob":"007","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1093054314","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44001679","medicareid":"7UF4X56WC93","medicaidid":"7UF4X56WC93","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E119","R6882","E782","E6601","E1165","S39012A","E7800","G9340","I10","N529","K047","R739","I160","Z794","R9089","R7309","R4182","G4733","E669","I639","R200","E1169","Z7189","Z87891","R29818","D72829","G4734","E785","M25512","L84","J40","J632","Z23","Z8673","S92252A","M5450","E1151","M2011","M2012","B351","M25774","Z6842","D869","F17210","G9389","R0902","R9082","Z79899","L905","Q6651","M84374D","M19071","Z98890","F17200","E66813","S92251A","M79671","J069","J320","R062","M960","H539","H538","R5383","R9389","S92253A","R471","R519","I161","S92901A","Z09","M62838","Q6652","M84374A","M84375A","M79672","Z716","M84375D","M542","M21541","Z981","I69322","R29701","Z888","Z9989","Z91199","G4489","R030","Z720","I6789","J4489","T8484XA","J9601","M21961","T465X6A","Z7982","Z91148","Z91048","Z889","Z6841","Z7985"],"date":["2026-06-05","2025-09-05","2024-04-15","2026-06-05","2026-05-14","2024-03-12","2024-03-12","2024-03-29","2026-05-14","2024-04-05","2024-03-31","2025-12-30","2025-12-30","2026-06-05","2024-03-25","2024-03-25","2024-03-25","2026-06-05","2024-04-13","2024-09-23","2024-12-23","2024-04-15","2026-01-05","2024-12-23","2025-02-21","2024-03-31","2025-07-15","2026-01-09","2024-07-02","2025-02-18","2024-10-03","2025-10-17","2024-12-23","2026-06-05","2025-09-05","2024-12-23","2025-02-18","2024-12-23","2024-12-23","2025-02-18","2024-12-23","2026-01-09","2024-03-23","2026-01-09","2024-03-23","2024-03-23","2024-04-13","2025-02-22","2024-06-10","2025-08-21","2025-06-12","2025-06-12","2025-06-23","2025-07-22","2025-07-15","2025-07-22","2026-05-05","2025-10-03","2025-10-17","2026-01-05","2026-06-05","2025-02-21","2025-02-21","2026-01-05","2025-01-27","2025-02-04","2025-02-21","2026-01-09","2025-02-22","2025-06-09","2026-01-20","2025-04-07","2025-05-06","2025-03-04","2025-03-04","2025-03-04","2025-04-21","2025-05-06","2025-05-27","2025-05-28","2025-09-25","2025-02-22","2025-02-22","2026-06-05","2025-05-28","2026-01-27","2026-01-08","2026-01-17","2026-02-27","2026-01-20","2026-04-01","2026-06-03","2026-01-09","2026-01-09","2026-01-09","2026-06-05","2026-01-09","2026-01-09","2026-01-09","2026-06-05","2026-06-05"],"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":[["","","DEXCOM G7 SENSOR","","","Select","Select",""],["","","CARVEDILOL","25 MG","","Select","Select",""],["","","HUMALOG KWIKPEN","","","Select","Select",""],["","","OLMESARTAN MEDOXOMIL\/AMLODIPINE\/HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","OZEMPIC","4 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","BACLOFEN","10 MG","","Select","Select",""],["","","DILTIAZEM HYDROCHLORIDE ER","300 MG","","Select","Select",""],["","","OXYCODONE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","IPRATROPIUM BROMIDE\/ALBUTEROL SULFATE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","40 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","BUPROPION HYDROCHLORIDE ER (SR)","150 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":""}]}]}