{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROGER W CRAIG","gend":0,"currentgend":"","add":"109 Locust St","city":"Junction City","state":"KS","zip":"66441","dob":"1952-04-07","age":"","mstatus":"","insh":"K44005995","cliId":"","pno":"8632071157","cno":"","email":"","ename":"","eno":"","pphy":"TANYA CASTOR","ppno":"7855393504","pcpadd":"1133 SW TOPEKA BLVD","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66503-7603","pcpcounty":"","pcpid":"","pcpname":"INSPIRE ENT & PULMONOLOGY PA","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1326130451","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44005995","medicareid":"1KF5R43HX81","medicaidid":"1KF5R43HX81","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R0902","L814","D1801","L853","L720","K429","I480","E782","I10","M7989","Z7901","I517","J441","M48061","M5126","M47816","M5442","R7303","D509","E039","M5136","Z9981","J449","E876","I890","K219","Z23","R2243","G4730","R600","I872","Z87891","R0781","M4807","R1900","J431","E785","E669","Z6834","I739","B351","I87391","L97522","E851","L02415","Z6835","Z993","Z79891","E1142","L03115","Z79899"],"date":["2026-04-02","2024-04-04","2024-04-04","2024-04-04","2024-04-04","2024-05-22","2024-07-26","2024-11-22","2025-10-16","2024-07-26","2025-06-18","2024-09-12","2024-12-16","2024-12-02","2024-12-02","2024-12-02","2024-01-29","2025-06-18","2024-03-19","2025-06-18","2024-01-29","2026-05-14","2025-10-02","2024-03-19","2026-05-01","2024-09-27","2025-10-16","2026-04-02","2025-11-10","2026-05-01","2025-05-07","2026-04-24","2025-06-18","2025-06-18","2025-06-18","2025-10-16","2025-10-16","2026-04-21","2026-03-19","2026-03-19","2026-03-19","2026-03-19","2026-05-01","2026-04-24","2026-04-21","2026-04-21","2026-05-14","2026-05-14","2026-05-01","2026-05-01","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":[["","","BUMETANIDE","1 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","20 MEQ","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","0.10%","","Select","Select",""],["","","GENTAMICIN SULFATE","0.10%","","Select","Select",""],["","","OXYCODONE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","IPRATROPIUM BROMIDE\/ALBUTEROL SULFATE","","","Select","Select",""],["","","OXYCODONE HYDROCHLORIDE","5 MG","","Select","Select",""],["","","METHYLPREDNISOLONE DOSE PACK","4 MG","","Select","Select",""],["","","TRELEGY ELLIPTA","100 MCG","","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":""}]}]}