{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID E WATT","gend":0,"currentgend":"","add":"7416 SW 22nd CT","city":"Topeka","state":"KS","zip":"66614","age":"","mstatus":"","insh":"K44009002","cliId":"","pno":"8152755077","cno":"","email":"dnw0873@gmail.com","ename":"","eno":"","pphy":"BRADLEY SCHROEDER","ppno":"7856549591","pcpadd":"2902 SW ASBURY DR","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66606-1670","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"7416 SW 22nd CT","madd2":"","madd3":"","mcity":"Topeka","mstate":"KS","mzip":"66614","pcpfaxno":"","pcpnpi":"1467480285","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44009002","medicareid":"7WX9HJ0DT11","medicaidid":"","pcpFlag":"","dob":"1952-07-08"},{"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":["J339","N281","K4090","K5730","K7689","Z96641","Z96642","R0789","R197","M549","D72829","R7309","R82998","Z7901","Z87891","J338","Z789","E782","Z86718","Z95828","K219","R7303","R9720","J4520","J069","Z86711","J324","Z01818","M25561","J329","I2510","T380X5A","J9811","M1611","Z1331","Z1339","D696","R311","A4902","Z96643","H6993","H6522","H906","E785","Z131","R739","I252","Z8614","Z7982","Z7951","Z79899","R519","R112","R42","R61","R0981","R17","R300","G501","H6982","J45909","Z0000","K1123"],"date":["2025-05-28","2025-06-30","2025-06-30","2025-06-30","2025-06-30","2026-02-05","2025-06-30","2025-06-30","2025-06-30","2025-06-30","2025-10-01","2025-06-30","2025-06-30","2026-04-07","2025-06-30","2026-04-29","2025-07-11","2026-04-07","2026-04-07","2025-10-01","2025-10-01","2026-04-07","2025-10-01","2025-10-01","2025-10-01","2026-04-07","2025-10-29","2025-01-28","2025-01-23","2026-04-07","2025-04-01","2025-02-12","2025-02-15","2025-02-12","2026-04-07","2026-04-07","2025-04-01","2025-04-01","2025-04-01","2026-02-05","2025-05-28","2025-05-14","2025-05-14","2025-02-12","2025-02-12","2025-02-12","2025-02-12","2025-02-12","2025-02-12","2025-02-12","2026-04-07","2025-02-15","2025-02-15","2025-02-15","2025-02-15","2025-02-15","2025-02-15","2026-01-22","2026-03-31","2026-03-31","2026-04-07","2026-04-07","2026-04-29"],"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":[["","","ELIQUIS","5 MG","","Select","Select",""],["","","POLYMYXIN B SULFATE\/TRIMETHOPRIM SULFATE","","","Select","Select",""],["","","FLUTICASONE PROPIONATE\/SALMETEROL","","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","75 MG","","Select","Select",""],["","","MUPIROCIN","2%","","Select","Select",""],["","","CIPROFLOXACIN HYDROCHLORIDE","500 MG","","Select","Select",""],["","","PREDNISOLONE ACETATE","1%","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","80 MG","","Select","Select",""],["","","WIXELA INHUB","","","Select","Select",""],["","","CELECOXIB","200 MG","","Select","Select",""],["","","TRAMADOL HYDROCHLORIDE","50 MG","","Select","Select",""],["","","OXYCODONE HYDROCHLORIDE","10 MG","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS","","","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":""}]}]}