{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RONALD L SHELTON","gend":0,"currentgend":"","add":"3221 NW HICKORY RIDGE LANE","city":"TOPEKA","state":"KS","zip":"66618","age":"","mstatus":"","insh":"K44004578","cliId":"","pno":"7852343373","cno":"7852243373","email":"RLSHELTON@ME.COM","ename":"","eno":"","pphy":"MICHAEL LEXOW","ppno":"7852331747","pcpadd":"2902 SW ASBURY DR","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66606-1696","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"3221 NW HICKORY RIDGE LANE","madd2":"","madd3":"","mcity":"TOPEKA","mstate":"KS","mzip":"66618","pcpfaxno":"","pcpnpi":"1275561185","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44004578","medicareid":"4R33CM8RR75","medicaidid":"","pcpFlag":"","dob":"1957-11-03"},{"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":["H04123","H11153","H5203","Z130","Z0000","E785","R7989","Z125","Z789","Z1329","Z131","R109","N200","R1030","R102","N3289","N281","R935","R9341","Z23","N329","F1020","M170","D2239","D224","D2261","D2262","D2271","D2272","D225","Z87891","D494","I517","C674","C678","N400","K760","N4289","R351","I10","Z9852","Z87442","R030","Z8551","M519","R3989","L821","N3080","N3020","I493","M62830","M9904","M25551","M9903","M5451","H35462","R1031","Z8739","N50811","G8929","M160","M4317","M438X7","M47816","M5416","R29898","N5082","C679","N210","R6889","I119","E669","Z6831","M51369","H25013"],"date":["2026-02-26","2024-02-13","2026-02-26","2024-02-29","2024-07-11","2025-12-30","2024-07-11","2025-07-25","2024-02-29","2024-02-29","2024-02-29","2024-07-05","2025-03-13","2024-07-11","2024-07-11","2024-07-11","2024-08-06","2024-07-18","2024-07-18","2024-07-11","2025-11-21","2024-07-11","2024-12-10","2024-07-23","2024-07-23","2024-07-23","2024-07-23","2024-07-23","2024-07-23","2024-07-23","2025-12-30","2025-07-02","2025-12-30","2025-12-30","2025-02-24","2024-07-11","2024-07-11","2024-07-11","2024-08-06","2025-03-25","2024-08-06","2026-01-12","2025-07-24","2025-12-30","2025-07-24","2025-12-19","2025-07-22","2025-08-18","2025-08-05","2025-12-30","2025-01-20","2025-01-20","2025-02-24","2025-01-20","2025-01-20","2025-02-20","2025-02-24","2025-02-24","2025-02-24","2025-02-24","2025-02-24","2025-03-06","2025-03-06","2025-03-06","2025-03-12","2025-04-11","2025-03-19","2025-03-13","2025-03-13","2025-04-11","2025-12-30","2025-12-30","2025-12-30","2025-03-06","2026-02-26"],"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":[["","","MELOXICAM","15 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","TRAMADOL HYDROCHLORIDE","50 MG","","Select","Select",""],["","","OXYCODONE HYDROCHLORIDE","5 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":""}]}]}