{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DONNA SCHWINDT","gend":1,"currentgend":"","add":"3817 Westland Pl","city":"Lawrence","state":"KS","zip":"66049","age":"","mstatus":"","insh":"K44007067","cliId":"","pno":"7857647737","cno":"","email":"schwindtdonna58@gmail.com","ename":"","eno":"","pphy":"CAITLIN ELMORE","ppno":"7855055070","pcpadd":"6265 ROCK CHALK DR","pcpcity":"LAWRENCE","pcpstate":"KS","pcpzip":"66049-5232","pcpcounty":"","pcpid":"","pcpname":"LMH HEALTH PRIMARY CARE - WEST CAMPUS","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1063909711","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44007067","medicareid":"8FA4C90WW06","medicaidid":"8FA4C90WW06","pcpFlag":"","dob":"1958-12-06"},{"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":["Z79891","M357","F32A","G43909","E6601","M5450","M25561","F439","F419","Z7689","E66812","Z6841","F17210","G8929","G4733","Z713","Z6835","L700","L988","Z6832","Z79899","Z791","Z7902","R413","Z6829","K621","K635","K5730","Z860100","R051","H1031","J029","H0288A","H0288B","H1045","M79642","G4719","M47816","E785","R519","E669","K219","R1310","Z8673","H109","H04031","H5711","F17200","F17209","M79672","M79675","M19072","I517","M549","M25562","W19XXXA","I959","Z98890","F331","L650","R220","Z6828","F430","M25462","M25461","M47812","M47814"],"date":["2026-05-27","2025-12-04","2026-05-27","2026-05-27","2025-07-21","2026-04-29","2026-03-31","2025-10-23","2025-12-29","2026-05-28","2025-06-23","2025-06-23","2026-05-28","2025-07-21","2026-02-24","2026-03-31","2025-08-25","2025-10-20","2025-10-20","2025-10-20","2026-05-06","2025-10-20","2026-05-28","2026-05-27","2025-12-29","2025-02-05","2025-05-20","2025-02-05","2025-02-05","2025-02-27","2025-02-27","2025-02-27","2025-04-14","2025-04-14","2025-04-14","2025-04-07","2025-04-25","2026-01-13","2025-04-15","2025-04-15","2025-05-06","2025-05-20","2025-05-20","2026-05-28","2025-02-27","2025-02-27","2025-02-27","2025-04-25","2025-05-29","2026-05-27","2026-05-27","2026-01-12","2026-01-15","2026-02-24","2026-01-13","2026-01-13","2026-05-06","2026-02-12","2026-02-24","2026-02-24","2026-03-31","2026-03-31","2026-05-06","2026-01-13","2026-01-13","2026-01-13","2026-01-13"],"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":[["","","LACTULOSE","10\/15 ML","","Select","Select",""],["","","SIMVASTATIN","40 MG","","Select","Select",""],["","","HYDROXYZINE HYDROCHLORIDE","25 MG","","Select","Select",""],["","","BUPROPION HYDROCHLORIDE ER (XL)","300 MG","","Select","Select",""],["","","FLUOXETINE HYDROCHLORIDE","40 MG","","Select","Select",""],["","","CLOPIDOGREL","75 MG","","Select","Select",""],["","","CELECOXIB","200 MG","","Select","Select",""],["","","TOPIRAMATE","100 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","ZEPBOUND","5\/0.5 ML","","Select","Select",""],["","","BREYNA","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","NURTEC","75 MG","","Select","Select",""],["","","ONDANSETRON HYDROCHLORIDE","4 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","","","Select","Select",""],["","","TWINRIX","","","Select","Select",""],["","","DULOXETINE HCL","30 MG","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","10 MG","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","METHYLPHENIDATE HYDROCHLORIDE","10 MG","","Select","Select",""],["","","OMEPRAZOLE","40 MG","","Select","Select",""],["","","NEOMYCIN\/POLYMYXIN\/DEXAMETHASONE","0.10%","","Select","Select",""],["","","POLYMYXIN B SULFATE\/TRIMETHOPRIM SULFATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","CLINDAMYCIN PHOSPHATE","1%","","Select","Select",""],["","","CONSTULOSE","10 GM","","Select","Select",""],["","","Fluoxetine Cap","40 MG","","Select","Select",""],["","","Hydroco\/Apap Tab 10-325Mg","","","Select","Select",""],["","","Twinrix Inj","","","Select","Select",""],["","","Hydroxyz Hcl Tab","25 MG","","Select","Select",""],["","","Topiramate Tab","100 MG","","Select","Select",""],["","","Fluzone Hd Inj 2025-26","","","Select","Select",""],["","","Doxycycl Hyc Cap","100 MG","","Select","Select",""],["","","Nurtec Tab","75 MG","","Select","Select",""],["","","Polymyxin B\/ Sol Trimethp","","","Select","Select",""],["","","Neo\/Poly\/Dex Sus 0.1% Op","","","Select","Select",""],["","","Methylphenid Tab","10 MG","","Select","Select",""],["","","Celecoxib Cap","200 MG","","Select","Select",""],["","","Clindamycin Sol 1%","","","Select","Select",""],["","","Zepbound Inj 7.5\/0.5","","","Select","Select",""],["","","Bupropion Tab","300 MG","","Select","Select",""],["","","Simvastatin Tab","40 MG","","Select","Select",""],["","","Zepbound Inj","5\/0.5 ML","","Select","Select",""],["","","Constulose Sol","10 GM","","Select","Select",""],["","","Lactulose Sol","10 GM","","Select","Select",""],["","","Zepbound Inj 2.5\/0.5","","","Select","Select",""],["","","Cyclobenzapr Tab","10 MG","","Select","Select",""],["","","Clopidogrel Tab","75 MG","","Select","Select",""],["","","Duloxetine Cap","30 MG","","Select","Select",""],["","","Albuterol Aer Hfa","","","Select","Select",""],["","","Prednisone Tab","10 MG","","Select","Select",""],["","","Omeprazole Cap","40 MG","","Select","Select",""],["","","Breyna Aer 160\/4.5","","","Select","Select",""],["","","Amox\/K Clav Tab 875-125","","","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":""}]}]}