{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANITA L MCMILLAN","gend":1,"currentgend":"","add":"7629 S 199th St West","city":"Viola","state":"KS","zip":"67149","age":"","mstatus":"","insh":"K44006122","cliId":"","pno":"3166501208","cno":"","email":"teammac@sktc.net","ename":"","eno":"","pphy":"NATHAN PFEIFER","ppno":"3167214544","pcpadd":"8200 W CENTRAL AVE","pcpcity":"WICHITA","pcpstate":"KS","pcpzip":"67212-3661","pcpcounty":"","pcpid":"","pcpname":"WEST WICHITA FAMILY PHYSICIANS","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO Box 295","madd2":"","madd3":"","mcity":"Clearwater","mstate":"KS","mzip":"67026","pcpfaxno":"","pcpnpi":"1750948188","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44006122","medicareid":"7K36MQ3DG47","medicaidid":"7K36MQ3DG47","pcpFlag":"","dob":"1952-05-04"},{"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":["M810","E119","E782","E210","H2513","H25013","H5015","H5203","M5114","M9901","M9903","I10","E785","K219","C642","Z85820","Z86010","M818","E559","L738","D1801","L578","Z08","L570","E6601","M79672","Z01811","Z01812","M5450","I4510","Z981","K5909","M48061","M47816","M4316","R2689","M6281","L821","L820","M79645","B9689","Z79899","M7062","M9906","M25552","H52223","H524","M5459","M720","M5416","M5412","M9902","J189","R000","Z20822","H6991","M7542","R509","R0600","Z23","Z885","R531","J9601","E8342","M8580","Z85528","Z905","Z90710","Z887"],"date":["2026-05-20","2026-05-20","2026-04-01","2026-05-20","2024-02-29","2024-02-29","2024-02-29","2025-02-24","2025-04-02","2025-04-02","2025-04-02","2026-05-20","2026-05-20","2025-12-02","2025-05-16","2026-02-24","2024-05-08","2025-12-02","2025-02-04","2025-11-25","2025-11-25","2024-11-21","2024-11-21","2025-11-25","2025-12-02","2024-11-08","2025-06-30","2025-06-30","2025-06-30","2026-05-20","2025-10-07","2025-07-13","2025-10-07","2025-10-07","2025-10-07","2025-11-26","2025-11-26","2025-11-25","2025-11-25","2025-12-19","2026-02-14","2026-05-20","2025-01-21","2025-04-02","2025-04-02","2026-03-23","2026-03-23","2025-04-15","2025-04-18","2025-05-16","2026-05-18","2026-05-18","2026-03-13","2026-02-22","2026-02-22","2026-03-13","2026-03-13","2026-02-22","2026-02-22","2026-05-20","2026-02-24","2026-02-24","2026-02-24","2026-02-24","2026-02-24","2026-02-24","2026-02-24","2026-02-24","2026-02-24"],"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":[["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","","","Select","Select",""],["","","TRAZODONE HYDROCHLORIDE","50 MG","","Select","Select",""],["","","METHYLPREDNISOLONE DOSE PACK","4 MG","","Select","Select",""],["","","BOOSTRIX","","","Select","Select",""],["","","AMLODIPINE BESYLATE","10 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","SIMVASTATIN","40 MG","","Select","Select",""],["","","LISINOPRIL","40 MG","","Select","Select",""],["","","LEVOFLOXACIN","500 MG","","Select","Select",""],["","","OZEMPIC","4 MG","","Select","Select",""],["","","CINACALCET HYDROCHLORIDE","30 MG","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","10 MG","","Select","Select",""],["","","OXYCODONE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","MELOXICAM","15 MG","","Select","Select",""],["","","METHOCARBAMOL","750 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","TRAMADOL HYDROCHLORIDE","50 MG","","Select","Select",""],["","","PREDNISONE","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":""}]}]}