{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOAN G PRICE","gend":1,"currentgend":"","add":"121 S ROCKHILL ST","city":"COUNCIL GROVE","state":"KS","zip":"66846","age":"","mstatus":"","insh":"K44009131","cliId":"","pno":"7854661363","cno":"","email":"","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"MANHATTAN MEDICAL GROUP LLC","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1295552099","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44009131","medicareid":"8Y21VY2PQ13","medicaidid":"8Y21VY2PQ13","pcpFlag":"","dob":"1938-08-08"},{"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":["N1832","M810","E6609","Z6834","M25552","E669","Z6833","L84","B351","R262","L603","M205X1","M205X2","Z9181","E663","I4891","I2510","Z4502","K921","D500","I5020","Z952","I517","I350","I2720","I361","Z7901","Z95810","Z713","H35371","H43813","H179","I129","N184","M79604","I358","I4819","R600","I739","I4720","I83893","M79605","I340","D122","K625","K640","R519","R42","K5900","Z860100","K5730","K641","E785","Z79899","N189","I509","E1122","R300","D638","R5383","K644","R748","R109","E039","I10","D509","K2980","I959","E559","E538","N281","R1013","K648","Z5309","K219","I130","N179","R531","I255","D696","D649","Z09","R062","D62","G4720","F410","Z5181","Z87891","Z951","Z8673","Z950","Z20822","R8271","K5904","Z860101","D631","R1084","R1012","R0789","I214","E860","E876","R000","G4733","M549","Z6827","Z8719","R112","R1010","I480","I5022","R7989","Z515","Z7189","I878","N186","I351","N1830","E874","Z66","K922","R197","K8590","I429","K529","I4820","K8510","E018","I5042","R55","Z45018"],"date":["2026-06-07","2026-05-13","2026-03-11","2025-07-09","2025-08-20","2026-01-14","2025-11-12","2025-08-14","2025-08-14","2025-08-14","2025-08-14","2025-08-14","2025-08-14","2025-08-14","2025-06-12","2026-06-08","2026-06-06","2025-10-02","2025-10-02","2026-04-03","2025-12-30","2026-06-07","2025-10-22","2025-10-22","2026-06-08","2025-10-22","2026-06-09","2026-06-07","2025-11-25","2025-12-01","2025-12-01","2025-12-01","2026-03-25","2026-05-13","2025-02-07","2026-06-03","2025-03-27","2026-05-13","2025-03-11","2026-06-09","2025-03-11","2025-02-07","2026-06-08","2025-03-21","2026-06-08","2025-03-21","2025-03-30","2026-06-01","2026-02-24","2025-04-25","2025-04-25","2025-04-25","2026-05-04","2026-06-07","2026-06-09","2026-03-31","2025-10-24","2025-10-24","2025-12-05","2025-12-24","2025-08-15","2026-05-14","2026-01-12","2026-01-06","2026-05-05","2026-03-31","2025-09-26","2025-10-08","2025-09-10","2025-09-10","2025-09-15","2025-09-15","2025-09-15","2025-09-26","2025-10-27","2026-03-17","2026-05-13","2025-12-24","2026-06-08","2026-06-09","2026-06-09","2026-03-31","2025-12-08","2026-01-06","2025-12-30","2025-12-30","2026-01-12","2026-03-25","2026-06-03","2025-03-11","2026-06-01","2026-03-15","2025-03-30","2025-04-25","2025-04-25","2026-05-13","2026-03-17","2026-03-17","2026-03-17","2026-03-25","2026-03-25","2026-03-25","2026-06-01","2026-03-25","2026-03-25","2026-03-11","2026-03-11","2026-05-14","2026-05-14","2026-06-07","2026-06-09","2026-06-07","2026-06-04","2026-06-04","2026-06-02","2026-06-03","2026-06-03","2026-06-08","2026-06-08","2026-06-08","2026-02-17","2026-03-15","2026-03-23","2026-04-03","2026-03-17","2026-03-17","2026-03-17","2026-03-17","2026-05-04","2026-06-01","2026-06-01"],"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":[["","","ISOSORBIDE MONONITRATE ER","60 MG","","Select","Select",""],["","","JARDIANCE","10 MG","","Select","Select",""],["","","BISOPROLOL FUMARATE","5 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","10 MEQ","","Select","Select",""],["","","ONDANSETRON ODT","4 MG","","Select","Select",""],["","","VERQUVO","2.5 MG","","Select","Select",""],["","","CALCITRIOL","0.25 MCG","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","25 MCG","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","METOLAZONE","2.5 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40 MG","","Select","Select",""],["","","AMIODARONE HYDROCHLORIDE","200 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","WARFARIN SODIUM","3 MG","","Select","Select",""],["","","ALLOPURINOL","100 MG","","Select","Select",""],["","","SUCRALFATE","1 GM","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","TRAMADOL HYDROCHLORIDE","50 MG","","Select","Select",""],["","","METOPROLOL SUCCINATE ER","25 MG","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","DIGOXIN","0.125 MG","","Select","Select",""],["","","SPIRONOLACTONE","25 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","ENTRESTO","26 MG","","Select","Select",""],["","","AZITHROMYCIN","500 MG","","Select","Select",""],["","","SACUBITRIL\/VALSARTAN","26 MG","","Select","Select",""],["","","ENOXAPARIN SODIUM","80\/0.8 ML","","Select","Select",""],["","","Sucralfate Tab","1 GM","","Select","Select",""],["","","Verquvo Tab","2.5 MG","","Select","Select",""],["","","Cephalexin Cap","500 MG","","Select","Select",""],["","","Entresto Tab 24-26Mg","","","Select","Select",""],["","","Sacub\/Valsar Tab 24-26Mg","","","Select","Select",""],["","","Warfarin Tab","3 MG","","Select","Select",""],["","","Metolazone Tab","2.5 MG","","Select","Select",""],["","","Levothyroxin Tab","50 MCG","","Select","Select",""],["","","Enoxaparin Inj","80\/0.8 ML","","Select","Select",""],["","","Azithromycin Tab","500 MG","","Select","Select",""],["","","Allopurinol Tab","100 MG","","Select","Select",""],["","","Furosemide Tab","20 MG","","Select","Select",""],["","","Pot Cl Micro Tab","20 MEQ","","Select","Select",""],["","","Tramadol Hcl Tab","50 MG","","Select","Select",""],["","","Gabapentin Cap","300 MG","","Select","Select",""],["","","Jardiance Tab","10 MG","","Select","Select",""],["","","Amiodarone Tab","100 MG","","Select","Select",""],["","","Prednisone Tab","20 MG","","Select","Select",""],["","","Pot Chloride Cap","10 MEQ","","Select","Select",""],["","","Calcitriol Cap","0.25 MCG","","Select","Select",""],["","","Pantoprazole Tab","40 MG","","Select","Select",""],["","","Digoxin Tab","0.125 MG","","Select","Select",""],["","","Spironolact Tab","25 MG","","Select","Select",""],["","","Bisoprol Fum Tab","5 MG","","Select","Select",""],["","","Atorvastatin Tab","20 MG","","Select","Select",""],["","","Isosorb Mono Tab","60 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":""}]}]}