{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN H FRANCE","gend":0,"currentgend":"","add":"2235 S CREST ST","city":"WICHITA","state":"KS","zip":"67207","dob":"1947-06-02","age":"","mstatus":"","insh":"K44002426","cliId":"","pno":"3162624084","cno":"","email":"patriciafrance14@gmail.com","ename":"","eno":"","pphy":"LUKE RECORDS","ppno":"3167883741","pcpadd":"1410 N WOODLAWN BLVD","pcpcity":"DERBY","pcpstate":"KS","pcpzip":"67037-2953","pcpcounty":"","pcpid":"","pcpname":"KANSAS MEDICAL CENTER LLC","plan":"BCBSKS","program":"Medicare","lob":"007","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1336580406","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44002426","medicareid":"6FM0W25MN18","medicaidid":"6FM0W25MN18","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":["R5383","R509","R059","E119","J449","R634","Z91199","R0602","I10","E785","I2510","F17210","Z122","E46","K449","I5022","R053","Z87891","J690","Z23","Z951","E782","I110","Z0000","B351","S81802A","N400","Z136","Z1211","F17200","Z125","N402"],"date":["2024-01-08","2024-01-08","2024-01-08","2026-06-15","2025-05-01","2024-01-25","2024-01-23","2024-02-27","2026-06-15","2026-06-08","2026-04-10","2026-04-10","2026-04-10","2026-04-10","2026-04-10","2026-04-10","2026-04-10","2024-07-08","2026-04-10","2025-05-01","2024-01-23","2024-01-23","2024-01-23","2025-04-30","2025-05-01","2025-05-01","2025-05-01","2025-05-01","2025-05-01","2025-05-01","2026-06-08","2026-06-15"],"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":[["","","CONTOUR NEXT BLOOD GLUCOSE TEST","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","40 MG","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE ER","500 MG","","Select","Select",""],["","","AMLODIPINE BESYLATE","2.5 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","ALBUTEROL SULFATE","0.08%","","Select","Select",""],["","","IPRATROPIUM BROMIDE","","","Select","Select",""],["","","MICROLET LANCETS","","","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":""}]}]}