{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHIRLEY L ROUDYBUSH","gend":1,"currentgend":"","add":"420 Milton St","city":"Auburn","state":"KS","zip":"66402","dob":"1944-08-27","age":"","mstatus":"","insh":"K44008132","cliId":"","pno":"7852562964","cno":"7859696232","email":"shirley.roudybush@gmail.com","ename":"","eno":"","pphy":"JESSICA BRYANT","ppno":"7858367111","pcpadd":"211 MAIN ST","pcpcity":"CARBONDALE","pcpstate":"KS","pcpzip":"66414-9607","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"420 Milton St","madd2":"","madd3":"","mcity":"Auburn","mstate":"KS","mzip":"66402","pcpfaxno":"","pcpnpi":"1710582788","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44008132","medicareid":"3A40AV3WX31","medicaidid":"3A40AV3WX31","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":["I10","E119","D500","G4733","M150","Z95818","S81811A","J449","J432","M5450","M9902","M546","H401111","H04123","H01021","H01024","E1159","T380X5A","I5032","J9601","B342","R0789","R82998","R7309","Z9981","Z87891","R918","I350","Z789","E6601","I2510","I6523","Z955","I517","I480","E039","J302","M542","I5031","J9811","J441","H401124","H401122","J440","I110","E1165","Z6841","J208","B9729","E782","Z7982","Z7984","Z881","Z882","Z96653","E871","R7989","R000","E785","I491","H16223","I872","B351","L03115"],"date":["2026-01-16","2025-06-20","2025-12-23","2025-12-27","2025-12-23","2026-02-23","2025-06-20","2025-12-26","2025-06-30","2026-03-10","2026-03-10","2026-03-10","2026-01-27","2025-07-29","2025-12-09","2025-12-09","2026-06-18","2025-12-30","2026-01-16","2025-12-27","2025-12-27","2025-12-27","2025-12-27","2025-12-27","2025-12-27","2025-12-27","2025-12-26","2026-01-16","2026-04-02","2025-12-27","2026-01-16","2026-01-16","2025-12-27","2025-12-28","2025-12-27","2026-01-05","2025-12-23","2025-09-08","2025-02-26","2025-03-29","2025-12-27","2025-04-28","2026-06-01","2025-12-27","2025-12-27","2026-06-18","2025-12-27","2025-12-27","2025-12-27","2025-12-27","2026-02-23","2025-12-27","2025-12-27","2025-12-27","2025-12-27","2026-01-08","2026-01-08","2026-01-16","2026-01-16","2026-01-16","2026-01-27","2026-05-07","2026-05-07","2026-05-30"],"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":[["","","AMLODIPINE BESYLATE","10 MG","","Select","Select",""],["","","LATANOPROST","0.01%","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","CLOPIDOGREL","75 MG","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE","500 MG","","Select","Select",""],["","","FUROSEMIDE","40 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","TIMOLOL MALEATE","0.50%","","Select","Select",""],["","","LISINOPRIL","10 MG","","Select","Select",""],["","","ANORO ELLIPTA","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","NITROGLYCERIN","0.4 MG","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","ERYTHROMYCIN","5 MG","","Select","Select",""],["","","SOTALOL HYDROCHLORIDE","80 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","LEVOFLOXACIN","750 MG","","Select","Select",""],["","","IPRATROPIUM BROMIDE\/ALBUTEROL SULFATE","","","Select","Select",""],["","","ALBUTEROL SULFATE","0.08%","","Select","Select",""],["","","Timolol Mal Sol 0.5% Op","","","Select","Select",""],["","","Nitroglycern Sub","0.4 MG","","Select","Select",""],["","","Sotalol Hcl Tab","80 MG","","Select","Select",""],["","","Albuterol Neb 0.083%","","","Select","Select",""],["","","Nystatin Pow 100000","","","Select","Select",""],["","","Anoro Ellipt Aer 62.5-25","","","Select","Select",""],["","","Ipratropium\/ Sol Albuter","","","Select","Select",""],["","","Latanoprost Sol 0.005%","","","Select","Select",""],["","","Furosemide Tab","40 MG","","Select","Select",""],["","","Levofloxacin Tab","750 MG","","Select","Select",""],["","","Lisinopril Tab","10 MG","","Select","Select",""],["","","Metformin Tab","500 MG","","Select","Select",""],["","","Prednisone Tab","20 MG","","Select","Select",""],["","","Cefdinir Cap","300 MG","","Select","Select",""],["","","Hydrochlorot Tab","25 MG","","Select","Select",""],["","","Erythromycin Oin","5 MG","","Select","Select",""],["","","Amlodipine Tab","10 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":""}]}]}