{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DONALD E SLOAN","gend":0,"currentgend":"","add":"3220 SW ALBRIGHT DR","city":"TOPEKA","state":"KS","zip":"66614","age":"","mstatus":"","insh":"K44006336","cliId":"","pno":"7856408699","cno":"","email":"bjwhitt1@icloud.com","ename":"","eno":"","pphy":"ANNE HOCHARD","ppno":"7853545225","pcpadd":"2601 SW 3RD ST","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66606-2438","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"6401 SW 64TH ST","madd2":"","madd3":"","mcity":"AUBURN","mstate":"KS","mzip":"664029667","pcpfaxno":"","pcpnpi":"1518494525","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44006336","medicareid":"4W49X88FN53","medicaidid":"4W49X88FN53","pcpFlag":"","dob":"1948-06-23"},{"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":["F03918","R4589","E11621","I10","D649","L97529","Z794","E1159","Z89412","S98112A","E119","Z89422","S0993XA","R609","M7989","G9389","R531","E871","R220","R7309","R7982","R519","H53142","R21","B0231","F419","F339","I739","L603","B351","E1140","R4182","R2681","Z79899","E538","F0390","L853","F329","F32A","R918","J986","S0181XA","A419","W19XXXA","K7689","K449","N400","K5730","J189","M47812","M47816","R112","D72829","R748","R7401","R7402","R946","W1839XA","Y929","S0181XD","Z9181","Z8639","R1032","Z8701","J690","E1165","E876","Z7982","S0121XA","Z20822","W19XXXD","L03116","G9341","F331","M6281"],"date":["2026-04-29","2024-01-16","2025-09-04","2026-04-29","2026-04-29","2025-09-04","2025-05-02","2024-04-23","2026-04-29","2024-02-06","2025-03-01","2024-12-10","2024-06-05","2024-06-05","2024-06-05","2024-10-29","2024-06-06","2025-03-01","2024-06-05","2024-06-05","2025-02-21","2024-06-05","2024-06-05","2024-06-05","2024-06-07","2024-07-04","2024-07-04","2025-02-20","2026-04-22","2026-04-22","2024-12-10","2025-02-21","2026-05-13","2025-02-21","2025-07-02","2026-05-14","2025-11-12","2026-04-29","2025-12-31","2025-02-21","2025-02-21","2025-02-25","2025-03-01","2025-02-25","2025-03-01","2025-03-01","2025-03-01","2025-02-21","2025-03-01","2025-02-21","2025-02-21","2025-02-21","2025-02-21","2025-02-21","2025-02-21","2025-02-21","2025-02-21","2025-02-21","2025-02-21","2025-03-12","2025-03-31","2025-03-12","2025-03-12","2025-03-31","2025-02-21","2025-02-21","2025-03-01","2025-02-21","2025-02-21","2025-02-21","2025-03-01","2025-03-01","2025-03-01","2026-05-14","2026-05-13"],"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":[["","","SERTRALINE HYDROCHLORIDE","100 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","LISINOPRIL","20 MG","","Select","Select",""],["","","SPIKEVAX COVID-19 VACCINE\/2025-26","","","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":""}]}]}