{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KYLE S DEAN","gend":0,"currentgend":"","add":"1639 N MARS ST","city":"WICHITA","state":"KS","zip":"672121148","age":"","mstatus":"","insh":"K44004788","cliId":"","pno":"3167222627","cno":"","email":"","ename":"","eno":"","pphy":"ASHTON YOUNGERS","ppno":"7855376264","pcpadd":"930 HAYES DR","pcpcity":"MANHATTAN","pcpstate":"KS","pcpzip":"66503-3002","pcpcounty":"","pcpid":"","pcpname":"HEARTLAND DERMATOLOGY CTR & SK","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"7858272515","pcpnpi":"1497127435","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44004788","medicareid":"9AD1T70MQ23","medicaidid":"9AD1T70MQ23","pcpFlag":"","dob":"1947-02-22"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L578","H25813","C109","I10","J449","H2511","Z91141","Z87891","Z85818","Z923","C069","R918","M4800","R1312","N400","I951","E871","L570","L850","G2581","G629","E785","H409","J309","F1010","Z9181","Z961","H25812","H401111","H2512","M5416","M62838","M4712","Z981","C760"],"date":["2024-01-10","2025-02-03","2024-08-14","2025-03-27","2026-03-11","2025-01-09","2024-10-18","2025-03-27","2024-08-14","2024-08-14","2025-02-03","2025-02-03","2025-02-03","2025-02-03","2026-03-11","2025-02-03","2025-02-03","2025-11-19","2025-02-03","2025-02-03","2025-02-03","2025-02-03","2025-02-03","2025-02-03","2025-02-03","2025-02-03","2026-03-30","2025-03-27","2025-01-09","2025-03-27","2026-03-11","2026-03-11","2026-03-11","2026-03-11","2026-03-11"],"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":[["","","CLINDAMYCIN PHOSPHATE","1%","","Select","Select",""],["","","PREDNISOLONE ACETATE","1%","","Select","Select",""],["","","MOXIFLOXACIN HYDROCHLORIDE","0.50%","","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":""}]}]}