{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PHILIP R BROWN","gend":0,"currentgend":"","add":"7649 312th Rd","city":"Arkansas City","state":"KS","zip":"67005","age":"","mstatus":"","insh":"K44004273","cliId":"","pno":"6204411412","cno":"6203263773","email":"brown@bcin.net","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"7649 312th Rd","madd2":"","madd3":"","mcity":"Arkansas City","mstate":"KS","mzip":"67005","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44004273","medicareid":"9EN0DN3GE42","medicaidid":"9EN0DN3GE42","pcpFlag":"","dob":"1953-02-24"},{"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":["E782","Z79899","Z125","M47896","M5136","I10","N451","M5431","M5416","M7541","M19011","M25411","M65342","M65332","M25511","M5116","M75101","M47816","D485","M48061","C4441","L03115","M12811","R600","M4807","G544","H25813","D3132","M9963","M48062","E785","M51360","D72829","E876","Z01818","Z01810","Z01811","Z01812","D62","M21371","E66811","R0683","G629","Z85828","Z6831","D508","M62838","N9989","R338","N401","R531","M159","Z98890"],"date":["2026-04-24","2026-03-06","2024-06-12","2025-03-28","2024-06-12","2026-05-27","2024-05-07","2026-06-03","2026-05-15","2025-08-11","2025-08-11","2025-08-11","2025-07-31","2025-07-31","2025-07-31","2025-08-11","2026-03-06","2026-05-27","2025-09-17","2025-09-17","2025-09-17","2025-09-17","2026-03-06","2025-03-04","2026-05-13","2026-03-24","2026-04-21","2026-04-21","2026-04-20","2026-05-15","2026-05-15","2026-05-22","2026-05-16","2026-05-16","2026-04-24","2026-04-24","2026-04-24","2026-04-24","2026-05-15","2026-05-15","2026-05-15","2026-05-15","2026-05-15","2026-05-15","2026-05-15","2026-06-03","2026-05-27","2026-05-22","2026-05-27","2026-05-27","2026-05-27","2026-05-27","2026-05-27"],"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":[["","","GABAPENTIN","300 MG","","Select","Select",""],["","","FINASTERIDE","5 MG","","Select","Select",""],["","","METHOCARBAMOL","750 MG","","Select","Select",""],["","","TAMSULOSIN HYDROCHLORIDE","0.4 MG","","Select","Select",""],["","","LEVOFLOXACIN","500 MG","","Select","Select",""],["","","LOSARTAN POTASSIUM","100 MG","","Select","Select",""],["","","AMLODIPINE BESYLATE","5 MG","","Select","Select",""],["","","OXYCODONE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","MELOXICAM","15 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","","","Select","Select",""],["","","PREDNISONE","20 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":""}]}]}