{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JANICE A ENDO","gend":1,"currentgend":"","add":"328 E 1100 Rd","city":"Baldwin City","state":"KS","zip":"66006","dob":"1943-03-26","age":"","mstatus":"","insh":"K44008229","cliId":"","pno":"9188013698","cno":"","email":"61grandmama@gmail.com","ename":"","eno":"","pphy":"BONNIE CRAMER","ppno":"7855055404","pcpadd":"406 AMES ST","pcpcity":"BALDWIN CITY","pcpstate":"KS","pcpzip":"66006-3099","pcpcounty":"","pcpid":"","pcpname":"LMH HEALTH PRIMARY CARE-BALDWIN CITY","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"7855055270","pcpnpi":"1194772707","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44008229","medicareid":"3QM9GU6VM17","medicaidid":"3QM9GU6VM17","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":["R0602","Z7689","M549","R634","E039","M810","B029","I4891","S066X0S","W19XXXA","S42022A","D509","I4821","Z7901","I5030","E8339","F419","F32A","S069X0A","I609","G4730","R269","M419","D72819","E876","I5043","I359","I351","I340","I361","I2720","I4820","Z950","E43","S066XAA","R188","J90","R160","J9811","K558","Z9189","W1830XA","S42002A","I7789","G3189","M47812","I672","I509","J9601","I608","G9389","Z8673","S066X0A","R2689","R251","G8911","G479","G4733","D62","F418","Z7409","S42018A","I110","I080","I5042","I5082","D72829","I4430","I081","Z79899","Z87891","I253","X58XXXA","I442","K120","D1801","L853","L659","L570","L814","D225","R600","R9431","R0609","I890","R609","W01198A","Z043","S42002D","F320","Z7984","Z79890","R748","Z9049","E8770","K1379","Q2110","S42012A","M19012","I2510","J9621","I4892","F329","Z66","E785","S066XAD","I5040","S42012D","Z23","Z9181","L989","D485","R140","R197","K56699","K37","C182","K561","I5032","K35890","C189","R7989","K56609","G629","I440","I071","L84","I739","R112","C180","R17","G8929","Z6820","Z483","R5381","Z6823","L89151"],"date":["2025-06-16","2026-04-10","2025-06-16","2025-07-14","2026-05-12","2026-05-12","2025-07-14","2026-05-12","2025-04-23","2025-05-02","2025-04-23","2025-05-02","2025-05-02","2026-04-14","2025-11-14","2026-03-23","2025-05-02","2025-04-23","2025-05-02","2025-05-14","2025-05-02","2025-05-02","2026-05-12","2025-05-02","2026-04-01","2025-04-25","2025-04-25","2025-04-25","2026-03-12","2025-04-25","2025-05-07","2025-05-07","2026-05-12","2026-05-12","2025-04-25","2026-03-15","2026-04-14","2025-04-23","2025-04-23","2025-04-23","2026-03-23","2025-04-24","2025-04-24","2025-04-23","2025-04-23","2025-04-23","2025-04-23","2025-05-05","2025-04-24","2025-04-24","2025-04-24","2025-04-24","2025-04-30","2025-04-25","2025-04-25","2025-04-24","2025-04-24","2026-05-12","2025-04-24","2025-04-24","2026-03-23","2025-04-24","2025-05-07","2025-04-25","2025-04-25","2025-05-07","2025-04-25","2026-05-12","2026-05-12","2026-02-24","2026-03-23","2025-11-11","2025-12-13","2026-02-23","2025-12-23","2025-10-15","2025-10-15","2025-10-15","2025-10-15","2025-03-03","2025-03-03","2026-02-24","2025-04-23","2025-04-10","2025-04-10","2026-02-23","2025-04-22","2025-04-23","2025-05-07","2026-05-12","2026-05-12","2025-05-05","2026-03-15","2026-04-14","2025-11-11","2025-12-13","2025-04-10","2025-04-23","2025-05-12","2025-04-23","2025-04-23","2025-04-23","2025-04-23","2026-03-23","2025-04-23","2025-05-07","2025-05-07","2025-05-07","2025-05-07","2025-05-07","2026-01-14","2026-01-30","2026-03-11","2026-03-11","2026-03-17","2026-03-13","2026-03-23","2026-04-10","2026-05-12","2026-03-13","2026-05-12","2026-03-23","2026-04-10","2026-05-12","2026-03-30","2026-03-30","2026-05-19","2026-05-19","2026-03-15","2026-03-23","2026-03-15","2026-03-15","2026-03-15","2026-03-23","2026-03-23","2026-03-23","2026-05-12"],"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":[["","","GABAPENTIN","100 MG","","Select","Select",""],["","","FUROSEMIDE","40 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","10 MEQ","","Select","Select",""],["","","SHINGRIX","50\/0.5 ML","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","25 MCG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","METOLAZONE","2.5 MG","","Select","Select",""],["","","JARDIANCE","10 MG","","Select","Select",""],["","","ELIQUIS","2.5 MG","","Select","Select",""],["","","SERTRALINE HCL","50 MG","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","SPIKEVAX COVID-19 VACCINE\/2025-26","","","Select","Select",""],["","","VALACYCLOVIR HYDROCHLORIDE","1 GM","","Select","Select",""],["","","TRAMADOL HYDROCHLORIDE","50 MG","","Select","Select",""],["","","SERTRALINE HYDROCHLORIDE","50 MG","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE DENTAL PASTE","0.10%","","Select","Select",""],["","","Cephalexin Cap","500 MG","","Select","Select",""],["","","Fluad Inj 2025-26","","","Select","Select",""],["","","Metolazone Tab","2.5 MG","","Select","Select",""],["","","Eliquis Tab","2.5 MG","","Select","Select",""],["","","Valacyclovir Tab","1 GM","","Select","Select",""],["","","Tramadol Hcl Tab","50 MG","","Select","Select",""],["","","Furosemide Tab","40 MG","","Select","Select",""],["","","Jardiance Tab","10 MG","","Select","Select",""],["","","Pot Chloride Cap","10 MEQ","","Select","Select",""],["","","Gabapentin Cap","100 MG","","Select","Select",""],["","","Spikevax Inj 2025-26","","","Select","Select",""],["","","Sertraline Tab","50 MG","","Select","Select",""],["","","Levothyroxin Tab","25 MCG","","Select","Select",""],["","","Triamcinolon Pst Den 0.1%","","","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":""}]}]}