{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LARRY J THOMAS","gend":0,"currentgend":"","add":"3511 SE TOMAHAWK COURT","city":"TOPEKA","state":"KS","zip":"66605","dob":"1953-10-07","age":"","mstatus":"","insh":"K44003690","cliId":"","pno":"7852675701","cno":"7858454497","email":"ljthomas900@yahoo.com","ename":"","eno":"","pphy":"DARYN SCHMIDT","ppno":"7856549591","pcpadd":"901 SW GARFIELD AVE","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66606-1670","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"007","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1326148511","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44003690","medicareid":"6NQ2Q07TK00","medicaidid":"6NQ2Q07TK00","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":["I87323","I83812","Z98890","Z8679","R3915","R351","Z0000","I10","E782","N400","C61","M5442","D171","G8929","H43393","R09A2","R1310","K219","K449","R1319","L989","N529","L820","D229","Z85828","R0683","M79644","M67431","Z8546","L919","L578","L814","N5235","H0288B","H2513","H5203","H52223","L570","M1811","M25531","H04123","H40013","H524","G4733","E66812","E6609","Z6835","I440","E785","G4730","J45909","E669","Z6834","Z887"],"date":["2024-03-25","2024-03-25","2024-03-25","2024-03-25","2025-03-20","2026-04-23","2024-06-17","2026-06-12","2026-06-10","2025-12-17","2026-06-16","2024-06-17","2024-06-17","2025-12-17","2025-04-08","2024-07-23","2024-09-05","2024-07-23","2024-09-05","2024-08-22","2024-12-13","2025-06-18","2025-07-21","2025-07-21","2025-07-21","2026-04-23","2026-06-10","2026-06-10","2026-06-12","2025-01-17","2025-01-17","2025-01-17","2026-05-28","2026-05-05","2025-04-08","2026-05-05","2026-05-05","2025-04-28","2026-04-15","2026-04-15","2026-05-05","2026-05-05","2026-05-05","2026-06-10","2026-06-10","2026-06-10","2026-06-10","2026-06-10","2026-06-12","2026-06-12","2026-06-12","2026-06-12","2026-06-12","2026-06-12"],"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":[["","","SOLIFENACIN SUCCINATE","10 MG","","Select","Select",""],["","","PRAVASTATIN SODIUM","40 MG","","Select","Select",""],["","","VALSARTAN","160 MG","","Select","Select",""],["","","AMLODIPINE BESYLATE","10 MG","","Select","Select",""],["","","TAMSULOSIN HYDROCHLORIDE","0.4 MG","","Select","Select",""],["","","OMEPRAZOLE","40 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS","","","Select","Select",""],["","","NEBIVOLOL HYDROCHLORIDE","10 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","PREDNISOLONE ACETATE","1%","","Select","Select",""],["","","COMIRNATY 2025-26","3 ML","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","COMIRNATY 2024-25","","","Select","Select",""],["","","FLUAD 2024-2025","","","Select","Select",""],["","","FLUOROURACIL","5%","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","Comirnaty Inj 2024-25","","","Select","Select",""],["","","Comirnaty Inj 30\/.3Ml","","","Select","Select",""],["","","Fluad Inj 2024-25","","","Select","Select",""],["","","Pravastatin Tab","40 MG","","Select","Select",""],["","","Fluad Inj 2025-26","","","Select","Select",""],["","","Valsartan Tab","160 MG","","Select","Select",""],["","","Solifenacin Tab","10 MG","","Select","Select",""],["","","Fluorouracil Cre 5%","","","Select","Select",""],["","","Tamsulosin Cap","0.4 MG","","Select","Select",""],["","","Abrysvo Inj","","","Select","Select",""],["","","Nebivolol Tab","10 MG","","Select","Select",""],["","","Omeprazole Cap","40 MG","","Select","Select",""],["","","Amlodipine Tab","10 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":""}]}]}