{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA L ORTON","gend":1,"currentgend":"","add":"178 TWAIN ARBOR RD","city":"ALMA","state":"KS","zip":"66401","age":"","mstatus":"","insh":"K44005147","cliId":"","pno":"7858263409","cno":"","email":"llorton2226@gmail.com","ename":"","eno":"","pphy":"KRYSTAL BRUNIN","ppno":"7852350335","pcpadd":"823 SW MULVANE ST","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66606-2814","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"178 TWAIN ARBOR RD","madd2":"","madd3":"","mcity":"ALMA","mstate":"KS","mzip":"66401","pcpfaxno":"","pcpnpi":"1649636549","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44005147","medicareid":"4XR8F52TQ24","medicaidid":"","pcpFlag":"","dob":"1951-03-17"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z853","E785","Z0000","Z6829","Z780","Z170","M8580","Z9013","H2513","H43393","H5203","H52223","H524","Z45018","I4891","Z7901","I459","E66811","Z6831","E782","K219","Z13228","I4430","M25552","G8929","M5442","M5450","M9902","M546","R0789","R42","C50112","I499","M85851","E034","M85852","E039","I440","I442","I495","Z950","I480","J342","Z87891","Z885","Z888","M549","R946","R7989","R82998","M542","K635","D128","K649","K621","D235","L720","I4892"],"date":["2024-04-09","2024-01-18","2026-01-21","2024-01-18","2026-04-09","2026-04-09","2026-04-09","2024-04-09","2025-06-20","2025-06-20","2025-06-20","2025-06-20","2025-06-20","2025-08-06","2026-01-21","2026-05-01","2025-07-30","2026-06-04","2025-10-27","2026-06-04","2026-06-04","2025-10-27","2026-03-31","2025-12-02","2025-12-02","2025-12-02","2026-03-20","2026-03-20","2026-03-20","2025-01-09","2026-02-28","2026-01-21","2025-01-20","2026-01-21","2025-01-20","2026-01-21","2026-05-01","2025-04-14","2025-05-20","2025-04-14","2025-04-28","2026-02-26","2025-05-12","2026-05-01","2026-05-01","2025-04-14","2026-02-28","2026-02-28","2026-02-28","2026-02-28","2026-02-03","2026-05-01","2026-05-01","2026-05-01","2026-05-01","2026-05-29","2026-05-29","2026-05-01"],"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":[["","","GABAPENTIN","100 MG","","Select","Select",""],["","","EZETIMIBE","10 MG","","Select","Select",""],["","","ONDANSETRON ODT","4 MG","","Select","Select",""],["","","OMEPRAZOLE DR","40 MG","","Select","Select",""],["","","METOPROLOL SUCCINATE ER","25 MG","","Select","Select",""],["","","SODIUM SULFATE\/POTASSIUM SULFATE\/MAGNESIUM SULFATE","","","Select","Select",""],["","","SYNTHROID","100 MCG","","Select","Select",""],["","","ELIQUIS","5 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","FENOFIBRATE","48 MG","","Select","Select",""],["","","COMIRNATY 2025-26","3 ML","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","TOPIRAMATE","25 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":""}]}]}