{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DONALD P CHRONISTER","gend":0,"currentgend":"","add":"2320 SW 36th St","city":"Topeka","state":"KS","zip":"66611","dob":"1948-01-07","age":"","mstatus":"","insh":"K44003475","cliId":"","pno":"7852501407","cno":"","email":"","ename":"","eno":"","pphy":"MELISSA TANGEMAN","ppno":"7852737224","pcpadd":"4505 NW FIELDING RD","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66614-5646","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"007","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"2320 SW 36th St","madd2":"","madd3":"","mcity":"Topeka","mstate":"KS","mzip":"66611","pcpfaxno":"","pcpnpi":"1235674532","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44003475","medicareid":"7QQ4QG7PQ92","medicaidid":"","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":["H2513","N529","M6289","N401","N3941","R278","N400","M25561","F17200","G4733","E6601","F1290","M0609","M25562","Z6837","G8929","Z87891","L570","D229","L820","L814","Z85828","L738","F17210","H04123","H01006","H01003","Z122","R509","R0602","R0789","J449","J441","J9601","E785","R0902","R0600","J189","R21","M5450","E782","F902","F411","F330","R350","M519","M48061","R531","R6889","R9389","N453","R197","N390","B9620","N138","L539","Z87440","Z720","N454","N451","Z716","E66812","G2401","D72829","R7982","Z7901","Z09","I440","J440","F32A","F419","G2581","G4700","I10","I2510","R61","M5116","R918","J984","N433","G20A1","Z6834","Z79899","N500","M069","E669","G4730","K219","F1210","Z888","Z6833","L219","B079","L821","L708","F17290","R911"],"date":["2025-03-13","2024-03-29","2024-07-12","2026-02-20","2025-01-22","2025-01-22","2025-06-19","2024-07-12","2025-06-19","2025-07-18","2024-07-12","2025-02-21","2025-02-21","2024-07-12","2024-07-12","2025-08-06","2025-07-18","2024-09-18","2026-04-17","2026-04-17","2026-04-17","2026-04-17","2024-09-18","2025-03-03","2024-09-19","2024-09-19","2024-09-19","2025-08-06","2025-06-18","2025-06-18","2025-06-18","2025-06-18","2025-06-20","2025-06-20","2025-06-20","2025-06-18","2025-06-18","2025-06-19","2025-07-18","2025-07-18","2025-07-18","2025-12-18","2025-07-18","2025-07-18","2025-07-18","2025-08-06","2025-08-06","2025-10-24","2025-12-18","2025-12-18","2025-03-03","2025-01-25","2025-02-27","2025-02-27","2025-04-03","2025-01-27","2025-04-03","2025-02-21","2025-04-03","2025-02-27","2025-02-21","2025-02-21","2025-02-21","2025-02-19","2025-02-19","2025-02-19","2025-02-26","2025-03-03","2025-06-19","2025-06-19","2025-06-19","2025-06-19","2025-06-19","2025-06-19","2026-02-06","2025-06-19","2025-08-06","2025-08-06","2025-08-06","2025-02-21","2025-03-03","2025-02-21","2025-02-21","2025-03-03","2025-03-03","2025-03-03","2025-03-03","2025-03-03","2025-03-03","2025-03-03","2025-03-03","2026-04-17","2026-04-17","2026-04-17","2026-04-17","2026-04-17","2026-03-05"],"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":[["","","SIMVASTATIN","40 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","0.10%","","Select","Select",""],["","","ROPINIROLE HCL","1 MG","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","LATANOPROST","0.01%","","Select","Select",""],["","","TRAZODONE HYDROCHLORIDE","100 MG","","Select","Select",""],["","","MELOXICAM","7.5 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","TAMSULOSIN HYDROCHLORIDE","0.4 MG","","Select","Select",""],["","","PAROXETINE HYDROCHLORIDE","20 MG","","Select","Select",""],["","","AMPHETAMINE\/DEXTROAMPHETAMINE","20 MG","","Select","Select",""],["","","TIMOLOL MALEATE","0.50%","","Select","Select",""],["","","BUPROPION HYDROCHLORIDE ER (XL)","300 MG","","Select","Select",""],["","","COMIRNATY 2025-26","3 ML","","Select","Select",""],["","","KETOCONAZOLE","2%","","Select","Select",""],["","","TIZANIDINE HYDROCHLORIDE","4 MG","","Select","Select",""],["","","CAPVAXIVE","0.5 ML","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS","","","Select","Select",""],["","","COMIRNATY 2024-25","","","Select","Select",""],["","","LEVOFLOXACIN","500 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","OXYCODONE 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":""}]}]}