{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARCIA A CHAPMAN","gend":1,"currentgend":"","add":"4213 TAMARISK CT","city":"LAWRENCE","state":"KS","zip":"66047","age":"","mstatus":"","insh":"K44003634","cliId":"","pno":"8163904426","cno":"","email":"melissa.johnson.0922@gmail.com","ename":"","eno":"","pphy":"ANDRA WALKER","ppno":"7855055070","pcpadd":"6265 ROCK CHALK DR","pcpcity":"LAWRENCE","pcpstate":"KS","pcpzip":"66049-5232","pcpcounty":"","pcpid":"","pcpname":"LMH HEALTH PRIMARY CARE - WEST CAMPUS","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"4213 TAMARISK CT","madd2":"","madd3":"","mcity":"LAWRENCE","mstate":"KS","mzip":"66047","pcpfaxno":"","pcpnpi":"1508041211","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44003634","medicareid":"7QJ6Y28QK64","medicaidid":"7QJ6Y28QK64","pcpFlag":"","dob":"1950-08-22"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","Z832","F32A","E669","Z6830","Z780","E785","Z8249","R29818","E7800","R931","Z8269","K449","R059","Z6831","Z7689","L570","Z789","M542","R531","M4003","R2681","N8110","M6289","R002","R42","Z79899","Z7185","K148","R1013","R339","R3915","N812","Z960","N952","Z0000"],"date":["2026-05-28","2024-01-19","2025-10-20","2026-02-19","2024-10-02","2025-02-10","2024-08-05","2024-06-26","2024-11-07","2026-05-28","2026-05-28","2025-06-04","2025-02-10","2024-11-07","2026-02-19","2026-05-28","2025-05-29","2025-06-04","2025-08-07","2025-08-07","2025-08-07","2025-08-07","2026-02-19","2025-10-20","2025-10-20","2026-02-19","2026-05-28","2025-10-20","2026-02-19","2025-02-10","2026-03-11","2026-02-16","2026-03-11","2026-03-11","2026-03-11","2026-02-19"],"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":[["","","COMIRNATY 2025-26","3 ML","","Select","Select",""],["","","ATORVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","ESTRADIOL","0.01%","","Select","Select",""],["","","EZETIMIBE","10 MG","","Select","Select",""],["","","SERTRALINE HYDROCHLORIDE","100 MG","","Select","Select",""],["","","IRBESARTAN\/HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","LAMOTRIGINE","100 MG","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","SHINGRIX","50\/0.5 ML","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","SERTRALINE HCL","50 MG","","Select","Select",""],["","","ATOMOXETINE","80 MG","","Select","Select",""],["","","ATOMOXETINE HYDROCHLORIDE","80 MG","","Select","Select",""],["","","FLUAD 2024-2025","","","Select","Select",""],["","","ONDANSETRON HYDROCHLORIDE","4 MG","","Select","Select",""],["","","SPIKEVAX COVID-19 VACCINE\/2024-25","","","Select","Select",""],["","","PRAVASTATIN SODIUM","80 MG","","Select","Select",""],["","","BOOSTRIX","","","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":""}]}]}