{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN R CURLEY","gend":0,"currentgend":"","add":"733 MARKET ST","city":"OSAGE CITY","state":"KS","zip":"665231161","age":"","mstatus":"","insh":"K44004965","cliId":"","pno":"7855284200","cno":"","email":"","ename":"","eno":"","pphy":"KYLIE HASTINGS","ppno":"7855283161","pcpadd":"131 W MARKET ST","pcpcity":"OSAGE CITY","pcpstate":"KS","pcpzip":"66523-1099","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1023485802","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44004965","medicareid":"4D54AK3QU99","medicaidid":"","pcpFlag":"","dob":"1946-12-22"},{"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":["G608","R262","L84","B351","L602","L603","L608","J441","G4752","G4733","R2681","H9193","F419","I10","I480","R42","G20B1","R531","K8020","K7460","M47892","S0083XA","M542","I951","W1839XA","Y929","G20B2","Z7901","L03116","S3991XA","R296","M6281","R2689","E669","M9902","M9903","M9904","M7918","E119","M4696","I77810","E6601","D508","Z6841","E785","Z87891","N401","R350","E782","Z0000","F5101","F331","E559","J449","K2100","J342","F3342","D649","R7401","R82998","M47895","M47896","J343","F339","F40240","G20A1","Z6835","J410","J9611","M7989","Z87442","I4891","I4581","I080","I77819","Z98890","Z9682","Z789","E7849","I4819","R918","R739","T380X5A","R0609","I058","I440","Z01810","D696","Z5181","Z79899","I5031","R310","N200","R351","I493","R609","M47816","F32A","N400","D62","S3012XD","Z8679","R17","X58XXXA","S8011XA","S3012XA","M7981","R1903","R791","L03115","M79661","M48061","Z96652","R9431","Z6838","Z4542","R0989","N135","I110","I083","K219","K709","Z6837","I358","E871","E1143","G250","Z8619","Z981","K7581","I509","G909","I700","I97638","I2510","L7634","D6832","I97630","T8141XA","T45515A","Z7409","M1711","Z9981","Z9181","Z1152","R051","R0902","R946","H04123","F410","H532","Z558","G629","I959","R9082"],"date":["2025-11-04","2026-05-11","2026-05-11","2026-05-11","2026-05-11","2026-05-11","2025-11-04","2024-01-02","2026-04-15","2026-04-15","2024-05-22","2024-01-02","2026-04-15","2026-03-25","2026-03-25","2024-03-25","2024-03-15","2024-03-15","2025-06-02","2026-03-25","2024-03-15","2024-03-15","2024-05-22","2025-07-03","2024-03-15","2026-02-18","2024-03-25","2026-03-25","2024-03-25","2024-03-15","2024-05-22","2024-05-22","2024-05-22","2025-08-19","2024-04-24","2024-04-24","2024-04-24","2024-04-24","2026-02-09","2026-02-09","2025-06-18","2026-02-09","2025-05-16","2025-12-05","2025-07-03","2026-02-18","2026-02-09","2026-02-09","2026-02-11","2024-11-20","2025-04-02","2025-12-05","2025-06-18","2025-12-05","2024-11-20","2024-12-05","2026-03-09","2025-07-03","2024-03-15","2024-03-15","2024-03-15","2024-03-15","2024-12-19","2025-08-19","2024-12-19","2026-02-09","2025-02-05","2025-06-18","2026-03-25","2025-11-19","2025-10-23","2026-02-11","2025-07-03","2025-07-03","2025-10-21","2026-03-25","2026-04-15","2026-04-15","2025-07-03","2025-11-14","2026-04-15","2025-10-23","2025-10-23","2025-09-03","2025-08-19","2025-11-14","2025-08-19","2026-02-09","2026-01-26","2026-01-26","2025-10-09","2026-02-09","2026-02-09","2026-02-09","2025-10-23","2025-10-22","2025-10-22","2025-10-23","2025-10-23","2025-11-19","2025-11-15","2025-11-19","2025-11-11","2026-02-18","2025-11-11","2026-01-26","2025-11-11","2025-11-11","2026-02-18","2025-11-19","2025-11-19","2026-02-09","2025-12-05","2025-02-05","2025-05-16","2026-01-07","2026-04-15","2025-06-02","2025-10-23","2025-07-03","2025-08-19","2025-07-03","2026-02-09","2025-10-23","2025-10-09","2025-10-09","2025-11-14","2025-11-14","2025-10-09","2025-10-09","2025-10-23","2025-11-14","2025-10-23","2025-10-23","2025-10-23","2025-11-14","2025-11-14","2025-11-14","2025-11-14","2025-11-14","2025-11-14","2026-02-09","2026-02-09","2026-02-09","2025-06-09","2026-01-06","2026-01-07","2026-02-18","2026-03-27","2026-04-15","2026-04-15","2026-03-10","2026-05-11","2026-03-10","2026-04-15"],"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":[["","","FUROSEMIDE","40 MG","","Select","Select",""],["","","CLONAZEPAM","1 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","ERYTHROMYCIN","0.50%","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","10 MEQ","","Select","Select",""],["","","TAMSULOSIN HYDROCHLORIDE","0.4 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","BUPROPION HYDROCHLORIDE ER (XL)","150 MG","","Select","Select",""],["","","SIMVASTATIN","20 MG","","Select","Select",""],["","","CITALOPRAM HYDROBROMIDE","20 MG","","Select","Select",""],["","","XARELTO","20 MG","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE","5 MG","","Select","Select",""],["","","SPIKEVAX COVID-19 VACCINE\/2025-26","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40 MG","","Select","Select",""],["","","AMIODARONE HYDROCHLORIDE","200 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","TRAMADOL HYDROCHLORIDE","50 MG","","Select","Select",""],["","","CEFADROXIL","500 MG","","Select","Select",""],["","","CEPHALEXIN","500 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":""}]}]}