{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RICHARD A PATTERSON","gend":0,"currentgend":"","add":"5525 SW 13th St","city":"Topeka","state":"KS","zip":"66604","age":"","mstatus":"","insh":"K44008611","cliId":"","pno":"7854092909","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":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44008611","medicareid":"9WR9WF6DY41","medicaidid":"","pcpFlag":"","dob":"1960-02-13"},{"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":["G4733","H903","H9313","N218","I10","E66813","E6601","Z6841","E269","E278","Z125","D229","R238","L918","Z5986","R200","I152","F5101","N182","H35413","N402","N3289","R0789","M79661","E66812","N1832","Z6839","N1830","J069","R058","M25551","W19XXXA","S79911A","M19011","Z96641","G4709","R5383","R062","R110","Z0000","N62","I129","H918X2","N528","T50905A","N1831","E782","Z1331","Z7189"],"date":["2025-06-26","2025-06-26","2025-06-26","2025-04-09","2026-02-04","2025-05-23","2025-04-09","2025-05-23","2026-05-26","2025-06-26","2026-02-04","2025-07-02","2025-07-02","2025-07-02","2025-07-02","2025-08-13","2026-05-26","2026-02-04","2025-10-13","2025-10-28","2025-10-31","2025-11-21","2025-01-03","2025-01-03","2025-01-09","2025-05-23","2025-01-09","2025-01-09","2025-03-27","2025-03-27","2025-04-04","2025-04-04","2025-04-04","2025-04-04","2025-04-04","2025-04-16","2025-04-16","2026-02-18","2025-05-23","2025-05-23","2025-05-23","2025-05-23","2025-05-23","2025-05-23","2025-05-23","2026-02-04","2026-05-21","2026-05-26","2026-05-26"],"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":[["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","80 MG","","Select","Select",""],["","","AMLODIPINE BESYLATE","10 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","SPIRONOLACTONE","25 MG","","Select","Select",""],["","","TRAZODONE HYDROCHLORIDE","100 MG","","Select","Select",""],["","","CARVEDILOL","25 MG","","Select","Select",""],["","","ONDANSETRON ODT","4 MG","","Select","Select",""],["","","SPIKEVAX COVID-19 VACCINE\/2025-26","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40 MG","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","BUDESONIDE\/FORMOTEROL FUMARATE DIHYDRATE","","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","10 MG","","Select","Select",""],["","","OMEGA-3-ACID ETHYL ESTERS","1 GM","","Select","Select",""],["","","BOOSTRIX","","","Select","Select",""],["","","TWINRIX","","","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":""}]}]}