{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBRA R LLOYD","gend":1,"currentgend":"","add":"313 N GRANDSTONE ST","city":"KECHI","state":"KS","zip":"67067","dob":"1958-10-02","age":"","mstatus":"","insh":"K44005796","cliId":"","pno":"6052614928","cno":"","email":"babynurseDRL@aol.com","ename":"","eno":"","pphy":"HAI TRUONG","ppno":"3166842851","pcpadd":"7111 E 21ST ST N","pcpcity":"WICHITA","pcpstate":"KS","pcpzip":"67206","pcpcounty":"","pcpid":"","pcpname":"PRIMARY CARE ASSOCIATES","plan":"BCBSKS","program":"Medicare","lob":"007","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"313 N GRANDSTONE ST","madd2":"","madd3":"","mcity":"KECHI","mstate":"KS","mzip":"67067","pcpfaxno":"3169272182","pcpnpi":"1821044173","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44005796","medicareid":"5MP0EV3VD02","medicaidid":"5MP0EV3VD02","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K222","E782","N952","Z23","M810","M8588","K219","Z90711","E669","Z6834","E66811","Z1231","J029","Z20822","J40","Z6835","Z1331","Z5320","H04123","R059","R12","E7800","R030","Z8719","Z860101","Z9049","Z9089","K5730","Q438","K642","R1310","K2100","K317","Z86718","E66812","Z6833","M5431","M9904","M7601","M9902","M546","R1084","R112","I420","K449","K4030","I4891","Z90710"],"date":["2025-03-31","2025-12-29","2025-12-29","2024-12-05","2024-12-05","2025-12-29","2026-04-02","2025-12-29","2024-12-05","2026-04-23","2026-04-23","2025-06-26","2025-10-29","2025-10-29","2025-10-29","2025-12-29","2025-12-29","2025-12-29","2025-10-27","2025-02-09","2025-02-25","2025-03-31","2025-02-25","2025-04-14","2025-02-25","2025-03-31","2025-02-25","2025-03-31","2025-03-31","2025-03-31","2025-03-31","2025-03-31","2025-03-31","2025-03-31","2025-04-14","2025-04-14","2026-03-30","2026-03-30","2026-03-30","2026-03-30","2026-03-30","2026-03-30","2026-03-30","2026-05-20","2026-04-23","2026-04-02","2026-04-02","2026-04-02"],"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":[["","","ATORVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","ESTRADIOL","0.01%","","Select","Select",""],["","","RESTASIS","0.05%","","Select","Select",""],["","","FAMOTIDINE","20 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","LANSOPRAZOLE","30 MG","","Select","Select",""],["","","AMIODARONE HYDROCHLORIDE","200 MG","","Select","Select",""],["","","ONDANSETRON HYDROCHLORIDE","4 MG","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","OXYCODONE HYDROCHLORIDE","5 MG","","Select","Select",""],["","","ELIQUIS","5 MG","","Select","Select",""],["","","Fluzone Hd Inj 2025-26","","","Select","Select",""],["","","Estradiol Cre 0.01%","","","Select","Select",""],["","","Amoxicillin Cap","500 MG","","Select","Select",""],["","","Famotidine Tab","20 MG","","Select","Select",""],["","","Restasis Emu 0.05% Op","","","Select","Select",""],["","","Lansoprazole Cap","30 MG","","Select","Select",""],["","","Atorvastatin Tab","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":""}]}]}