{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROBERT L WHYDE","gend":0,"currentgend":"","add":"112 W Madison Ave","city":"Arkansas City","state":"KS","zip":"67005","dob":"1950-11-01","age":"","mstatus":"","insh":"K44003478","cliId":"","pno":"6203071223","cno":"6203701223","email":"","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","plan":"BCBSKS","program":"Medicare","lob":"006","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"112 W Madison Ave","madd2":"","madd3":"","mcity":"Arkansas City","mstate":"KS","mzip":"67005","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44003478","medicareid":"4KA1PM9WY90","medicaidid":"4KA1PM9WY90","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":["M19042","M5450","W11XXXA","Y939","Y92019","Z0389","R0789","R109","H04123","H5203","H52223","H524","M19041","E119","E782","Z79899","Z125","Z1159","L218","M158","M47896","R7303","I2510","L570","N401","R768","R911","S8991XA","M47817","F330","R918","R059","Z20822","J432","K120","T17998S","K219","Z01812","R52","R051","R0902","K8020","R2232"],"date":["2024-02-28","2024-08-02","2024-08-02","2024-08-02","2024-08-02","2024-08-02","2024-08-02","2024-08-02","2024-12-18","2024-12-04","2024-12-04","2024-12-04","2024-02-28","2025-05-09","2025-08-15","2025-08-15","2025-08-15","2024-01-03","2024-06-06","2024-01-03","2025-08-15","2026-03-11","2026-03-11","2025-05-09","2024-02-28","2024-06-06","2025-11-06","2024-10-19","2024-12-18","2026-03-11","2024-12-18","2025-01-14","2025-01-14","2025-01-02","2025-08-15","2025-08-15","2026-03-11","2025-01-02","2025-01-14","2025-01-14","2025-01-14","2025-01-31","2026-05-19"],"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":[["","","ATORVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","KETOCONAZOLE","2%","","Select","Select",""],["","","TAMSULOSIN HYDROCHLORIDE","0.4 MG","","Select","Select",""],["","","OMEPRAZOLE","40 MG","","Select","Select",""],["","","MELOXICAM","15 MG","","Select","Select",""],["","","BUPROPION HYDROCHLORIDE ER (SR)","150 MG","","Select","Select",""],["","","TRAZODONE HYDROCHLORIDE","100 MG","","Select","Select",""],["","","CITALOPRAM HYDROBROMIDE","10 MG","","Select","Select",""],["","","MNEXSPIKE COVID-19 VACCINE\/2025-26","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE DENTAL PASTE","0.10%","","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":""}]}]}