{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KATHRYN D COOPER","gend":1,"currentgend":"","add":"140 S LYNWOOD ST","city":"WICHITA","state":"KS","zip":"67218","dob":"1946-06-12","age":"","mstatus":"","insh":"K44002488","cliId":"","pno":"5756442964","cno":"","email":"KATHCOO46@GMAIL.COM","ename":"","eno":"","pphy":"RICHA SHARMA","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":"1669408480","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44002488","medicareid":"5DV1MU4XM24","medicaidid":"5DV1MU4XM24","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":["Z7901","J309","G4733","I2720","K219","E212","J4530","I480","M810","C50919","I87309","Z6842","Z0000","I890","H2513","H35363","H524","Z170","E8352","L810","L859","L905","H40021","I10","I351","M5440","Z6841","M5126","M5136","M4316","E6601","J322","J323","R930","H9203","Z9049","C089","M8668","J329","M19012","Z98890","J324","Z789","J320","M2601","I4891","G4730","Z79811","Z853","Z881","Z880","I517","K449","J0130","J342","M8550","B9561","L821","Z08","Z85828","D485","L858","H04123","H40023","S4991XA","Z96611","Z79899","R296","M549","C44519","M1990","R059","Z743","R9389","A498","B965","R845","Z792","A310","J189","A4901","S40011A","J45909","R509","I4710","R519","S0003XA","M797","E213","Z791","R911","I4719","I371","I083","Z9109","L578","Z950","Z006","I3139","Z95818","I352","I361","Z01811","Z01812","R001","R9431","Z7902","E049","I739","E210","R7303","Z7982","Z8701","I340"],"date":["2026-03-27","2025-10-24","2026-05-08","2026-04-23","2026-03-27","2024-01-26","2026-03-27","2026-03-28","2026-03-27","2026-01-27","2026-01-27","2025-01-09","2025-10-24","2024-02-15","2024-03-25","2024-03-25","2026-06-15","2025-09-08","2025-09-02","2024-05-07","2024-05-07","2024-05-07","2024-06-13","2026-05-08","2026-01-27","2024-07-01","2026-01-27","2024-09-03","2024-09-03","2024-09-03","2025-08-14","2026-01-08","2024-11-26","2024-10-14","2024-10-14","2024-10-14","2024-10-14","2024-11-26","2026-02-04","2024-11-25","2026-04-29","2026-04-29","2024-12-19","2026-01-27","2024-11-26","2025-08-21","2024-08-06","2024-08-06","2026-05-08","2026-05-08","2026-05-08","2025-10-09","2026-03-09","2024-11-26","2024-11-26","2024-11-26","2026-06-08","2026-01-22","2026-01-22","2026-01-22","2025-09-25","2025-07-17","2026-06-15","2026-06-15","2025-08-22","2025-08-22","2026-05-08","2025-08-21","2025-08-21","2025-09-25","2026-03-28","2025-10-24","2025-08-22","2026-04-23","2026-06-08","2025-11-20","2025-11-20","2026-06-08","2026-05-06","2025-12-11","2026-01-07","2025-08-22","2025-01-30","2025-01-30","2025-02-20","2025-02-13","2025-08-22","2026-03-27","2025-09-23","2025-09-23","2025-10-09","2025-01-09","2026-03-28","2025-01-09","2026-01-08","2026-01-22","2026-03-27","2026-03-27","2026-05-08","2026-03-28","2026-03-28","2026-03-28","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-05-08","2026-03-27","2026-03-27","2026-03-27","2026-03-27","2026-05-08","2026-03-27","2026-05-08"],"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":[["","","ALENDRONATE SODIUM","35 MG","","Select","Select",""],["","","CIPROFLOXACIN HYDROCHLORIDE","0.30%","","Select","Select",""],["","","DEXAMETHASONE SODIUM PHOSPHATE","0.10%","","Select","Select",""],["","","WARFARIN SODIUM","3 MG","","Select","Select",""],["","","MOMETASONE FUROATE","50 MCG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","NITROFURANTOIN MONOHYDRATE","100 MG","","Select","Select",""],["","","SOTALOL HYDROCHLORIDE","80 MG","","Select","Select",""],["","","BUDESONIDE\/FORMOTEROL FUMARATE DIHYDRATE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","TOBRAMYCIN","300\/5 ML","","Select","Select",""],["","","NITROFURANTOIN MONOHYDRATE\/MACROCRYSTALS","100 MG","","Select","Select",""],["","","AMLODIPINE BESYLATE","2.5 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","CLINDAMYCIN HYDROCHLORIDE","300 MG","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","75 MG","","Select","Select",""],["","","SOTALOL HCL","80 MG","","Select","Select",""],["","","MUPIROCIN","2%","","Select","Select",""],["","","BREYNA","","","Select","Select",""],["","","CLOPIDOGREL","75 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40 MG","","Select","Select",""],["","","COLCHICINE","0.6 MG","","Select","Select",""],["","","Sotalol Hcl Tab","80 MG","","Select","Select",""],["","","Dexameth Pho Sol 0.1% Op","","","Select","Select",""],["","","Cephalexin Cap","500 MG","","Select","Select",""],["","","Warfarin Tab","3 MG","","Select","Select",""],["","","Oseltamivir Cap","75 MG","","Select","Select",""],["","","Clindamycin Cap","300 MG","","Select","Select",""],["","","Tobramycin Neb","300\/5 ML","","Select","Select",""],["","","Mometasone Spr","50 MCG","","Select","Select",""],["","","Budes\/Formot Aer 80-4.5","","","Select","Select",""],["","","Doxycycl Hyc Tab","100 MG","","Select","Select",""],["","","Alendronate Tab","35 MG","","Select","Select",""],["","","Breyna Aer 80\/4.5","","","Select","Select",""],["","","Hydroco\/Apap Tab 5-325Mg","","","Select","Select",""],["","","Ciprofloxacn Sol 0.3% Op","","","Select","Select",""],["","","Amlodipine Tab","2.5 MG","","Select","Select",""],["","","Nitrofurantn Cap","100 MG","","Select","Select",""],["","","Prednisone Tab","10 MG","","Select","Select",""],["","","Albuterol Aer Hfa","","","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":""}]}]}