{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARLA J WILLIAMS","gend":1,"currentgend":"","add":"6435 SW 23RD ST","city":"TOPEKA","state":"KS","zip":"66614","dob":"1950-02-06","age":"","mstatus":"","insh":"K44002772","cliId":"","pno":"7852719203","cno":"","email":"majopaw@cox.net","ename":"","eno":"","pphy":"TARA CUNNINGHAM","ppno":"7853546000","pcpadd":"823 SW MULVANE ST","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66604-1301","pcpcounty":"","pcpid":"","pcpname":"ORTHOKANSAS AFFILIATE OF LMH","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"6435 SW 23RD ST","madd2":"","madd3":"","mcity":"TOPEKA","mstate":"KS","mzip":"66614","pcpfaxno":"7858433176","pcpnpi":"1114683810","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44002772","medicareid":"2JH8VV2YE40","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01810","I480","I483","I10","Z98890","Z7901","Z8679","I079","I459","I491","Z95818","E785","D649","Z0000","E789","R92323","Z803","K219","E669","Z6838","Z86718","Z91040","Z79899","Z91013","Z780","I119","F1090","M48061","Z6839","Z7982","Z01818","G8929","R7309","M25572","G3184","R0683","L989","Z967","G629","Z472","R0602","I2699","J9811","I4891","K52839","Z7409","Z791","M19072","Z7689","Z1231","E6601","M8580","Z86711","I878","Z981","I872","R0789","R61","R7989","K589","E782","M19071","R413","R0681","I781","L905","Z4789","M19172","R4181","Z993","F0390","G441","G43909","I2694","M7918","H9313","G44209","M7989"],"date":["2024-01-04","2026-04-28","2024-01-04","2025-10-20","2026-01-12","2026-04-28","2024-09-24","2024-03-28","2024-03-29","2024-03-28","2025-09-11","2025-10-20","2025-10-01","2025-10-01","2024-09-19","2026-04-07","2026-04-07","2025-10-20","2025-10-20","2025-07-22","2025-10-01","2024-01-02","2025-07-31","2024-05-08","2025-10-01","2024-05-08","2024-05-08","2026-04-28","2025-10-20","2024-05-08","2025-06-23","2025-06-23","2025-06-20","2026-01-07","2025-07-02","2025-07-02","2025-06-16","2026-01-21","2025-07-22","2025-07-15","2025-08-13","2025-08-13","2025-08-13","2025-08-13","2025-10-20","2025-07-31","2025-10-20","2025-08-11","2026-04-20","2025-10-01","2025-10-01","2025-10-01","2025-10-01","2025-08-15","2026-01-07","2025-08-13","2025-08-13","2025-08-13","2025-08-13","2025-12-04","2025-03-12","2025-05-20","2025-05-20","2025-05-20","2025-05-29","2025-05-29","2025-07-22","2025-07-22","2025-07-22","2025-10-20","2026-06-08","2026-01-05","2026-04-28","2026-04-28","2026-04-28","2026-04-28","2026-06-08","2026-01-12"],"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":[["","","GABAPENTIN","100 MG","","Select","Select",""],["","","FAMOTIDINE","20 MG","","Select","Select",""],["","","FLUTICASONE PROPIONATE","50 MCG","","Select","Select",""],["","","ONDANSETRON HYDROCHLORIDE","4 MG","","Select","Select",""],["","","OXYCODONE HYDROCHLORIDE","5 MG","","Select","Select",""],["","","XARELTO","20 MG","","Select","Select",""],["","","METOPROLOL SUCCINATE ER","25 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","TRAMADOL HYDROCHLORIDE","50 MG","","Select","Select",""],["","","ABRYSVO","120 MCG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","MELOXICAM","15 MG","","Select","Select",""],["","","LISINOPRIL","20 MG","","Select","Select",""],["","","XARELTO STARTER PACK","15\/20 MG","","Select","Select",""],["","","BUDESONIDE","3 MG","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","10 MG","","Select","Select",""],["","","DONEPEZIL HYDROCHLORIDE","5 MG","","Select","Select",""],["","","DONEPEZIL HCL","10 MG","","Select","Select",""],["","","MEMANTINE HYDROCHLORIDE","5 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":""}]}]}