{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VIRGIL L GRAHAM","gend":0,"currentgend":"","add":"1440 SW Belle","city":"Topeka","state":"KS","zip":"66604","age":"","mstatus":"","insh":"K44004094","cliId":"","pno":"7852726358","cno":"7852494359","email":"virgilg@swbell.net","ename":"","eno":"","pphy":"DEREK FRITZ","ppno":"7852324248","pcpadd":"2840 SW URISH RD","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66606-1663","pcpcounty":"","pcpid":"","pcpname":"TOPEKA PHYSICIAN GROUP LLC","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1440 SW Belle","madd2":"","madd3":"","mcity":"Topeka","mstate":"KS","mzip":"66604","pcpfaxno":"7853792457","pcpnpi":"1982264305","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44004094","medicareid":"8AY7AM8FA48","medicaidid":"8AY7AM8FA48","pcpFlag":"","dob":"1949-01-18"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":{"0":{"a":{"diag":["Z7901","I4821","I4891","I25708","I255","I440","I10","Z95810","I469","I493","I119","E782","M2550","M25541","M25542","R9720","I4820","R3129","M19042","M5451","M9904","M9905","M9902","M546","G4733","M9901","M542","E119","E611","N1830","M9903","R5383","E559","G2581","G4752","H35363","Z961","I252","I130","I5022","Z951","Z9989","Z8249","Z833","Z7982","Z7902","Z79899","Z7984","M19072","Z8674","M170","M2392","R454","F5101","N400","Z7689","H43822","H40013","Z98890","Z9841","Z9842","I4892","Z950","E1122","I2510","R051","Z1159","E785","I25119","Z885","M25562","H35342","G8929","Z1211","Z713","Z7182","E66811","E6609","Z6831","Z1212","H43821"],"date":["2026-06-18","2026-05-21","2026-04-23","2026-04-08","2026-04-02","2025-12-04","2026-04-08","2026-04-02","2026-02-01","2026-02-01","2026-02-01","2026-02-01","2024-03-26","2024-03-21","2024-03-21","2024-03-21","2025-04-17","2024-04-26","2024-04-26","2026-04-27","2024-09-24","2024-09-24","2026-04-27","2026-04-27","2026-04-08","2024-09-24","2026-04-27","2026-04-08","2026-04-08","2025-11-11","2026-04-27","2026-02-01","2024-12-03","2026-04-08","2024-12-03","2026-05-12","2024-12-20","2024-03-11","2024-03-11","2026-04-08","2025-11-11","2024-03-11","2024-03-11","2024-03-11","2024-03-11","2024-03-11","2026-01-20","2024-03-11","2024-04-26","2024-09-10","2025-06-19","2025-06-19","2025-07-14","2025-07-14","2025-07-14","2025-07-14","2026-05-12","2025-08-04","2026-01-21","2026-01-21","2026-01-21","2025-11-11","2026-04-02","2025-11-11","2025-11-11","2025-12-22","2025-07-14","2025-11-11","2025-11-11","2025-11-11","2026-06-17","2026-05-12","2026-06-17","2026-04-08","2026-04-08","2026-04-08","2026-04-20","2026-04-20","2026-04-20","2026-05-02","2026-05-12"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},"1":{"a":[]},"3":{"a":{"indx":["1",""],"comment":["",""],"sub":[]}}}},{"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":[["","","ZOLPIDEM TARTRATE","10 MG","","Select","Select",""],["","","OFLOXACIN","0.30%","","Select","Select",""],["","","CARVEDILOL","12.5 MG","","Select","Select",""],["","","SHINGRIX","50\/0.5 ML","","Select","Select",""],["","","TAMSULOSIN HYDROCHLORIDE","0.4 MG","","Select","Select",""],["","","LOSARTAN POTASSIUM","50 MG","","Select","Select",""],["","","FINASTERIDE","5 MG","","Select","Select",""],["","","EZETIMIBE","10 MG","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","AMLODIPINE BESYLATE","5 MG","","Select","Select",""],["","","JARDIANCE","10 MG","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","40 MG","","Select","Select",""],["","","WARFARIN SODIUM","5 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","10 MEQ","","Select","Select",""],["","","VENLAFAXINE HYDROCHLORIDE ER","75 MG","","Select","Select",""],["","","OZEMPIC","2 MG","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE ER","500 MG","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","PREDNISOLONE ACETATE","1%","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","PREVNAR 20","","","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":""}]}]}