{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBORAH K KENNEDY","gend":1,"currentgend":"","add":"3808 SW Canterbury Town Rd","city":"Topeka","state":"KS","zip":"66610","age":"","mstatus":"","insh":"K44006695","cliId":"","pno":"7853640774","cno":"","email":"","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"3808 SW Canterbury Town Rd","madd2":"","madd3":"","mcity":"Topeka","mstate":"KS","mzip":"66610","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44006695","medicareid":"5H29KV2FG16","medicaidid":"","pcpFlag":"","dob":"1959-04-16"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z131","E782","Z130","N838","N841","Z79899","Z780","Z13820","R4701","R29810","R4781","R471","R82998","E039","W1839XA","Y9289","N83201","I480","G4700","F410","F411","G459","H524","H02881","H02885","H2513","N739","I4891","E785","R1909","E038","I340","F419","Z23","Z1211","Z1239","Z124","Z122","Z6825","F331","R29701","Z8673","I499","Z79890","Z7901","Z7982","R92323","D2239","L821","L578","L815","M85851","M85852","E663","Z6826","R102","D485","Z7902"],"date":["2024-04-04","2025-10-17","2024-04-04","2024-05-22","2024-05-22","2026-03-18","2024-05-23","2024-05-23","2024-07-10","2024-07-10","2024-07-09","2024-07-09","2024-07-09","2026-03-18","2024-07-09","2024-07-09","2024-06-17","2026-03-26","2026-05-22","2026-05-22","2026-05-22","2025-10-17","2024-11-05","2024-11-05","2024-11-05","2024-11-05","2024-11-13","2024-11-13","2026-03-18","2024-11-13","2025-05-09","2025-05-09","2025-05-09","2024-05-06","2025-05-09","2025-05-09","2024-05-06","2024-05-06","2024-08-05","2025-05-20","2024-07-10","2026-03-18","2024-08-26","2025-05-31","2026-04-03","2026-03-18","2025-06-18","2025-02-28","2025-02-28","2025-02-28","2025-02-28","2025-05-09","2025-05-09","2025-05-09","2025-05-09","2025-06-05","2026-01-09","2026-03-18"],"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":[["","","CLONAZEPAM","0.5 MG","","Select","Select",""],["","","LIOTHYRONINE SODIUM","5 MCG","","Select","Select",""],["","","PROGESTERONE","100 MG","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","50 MCG","","Select","Select",""],["","","ESCITALOPRAM OXALATE","20 MG","","Select","Select",""],["","","ELIQUIS","5 MG","","Select","Select",""],["","","METOPROLOL TARTRATE","25 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40 MG","","Select","Select",""],["","","ONDANSETRON ODT","4 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","80 MG","","Select","Select",""],["","","ESTRADIOL","0.01%","","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":""}]}]}