{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WESLEY A LEWIS","gend":0,"currentgend":"","add":"4154 SW 6TH AVE","city":"TOPEKA","state":"KS","zip":"66606","age":"","mstatus":"","insh":"K44009420","cliId":"","pno":"9132711474","cno":"","email":"","ename":"","eno":"","pphy":"LEE LEINWETTER","ppno":"7852711818","pcpadd":"1031 SW FLLEMING CT","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66614-5616","pcpcounty":"","pcpid":"","pcpname":"TOPEKA PHYSICIAN GROUP LLC","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"Apt 120","add3":"","madd1":"4154 SW 6TH AVE","madd2":"Apt 120","madd3":"","mcity":"TOPEKA","mstate":"KS","mzip":"66606","pcpfaxno":"7853792457","pcpnpi":"1841412376","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44009420","medicareid":"4T18KG1QJ56","medicaidid":"","pcpFlag":"","dob":"1985-02-08"},{"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":["G8220","N319","Z79891","Z0000","N390","L89322","K592","G8921","Z7409","Z720","L89620","L89153","L89323","L03116","Y998","M792","L89623","L89610","L89329","L89159","E876","B9683","K5903","L02416","R201","R936","L919","T148XXD","F1190","Z09","L89622","R151","K429","Z9989","L89154","L89311","L89312","G8918","G8222","F1120","G894","F17200","F1193","N312","T24211A","T24212A","R7881","G8221","Z1619","Z59868","R8271","R5383","G8929","Z5329","F17210","L89324","Z993","Z886","Z888","Z885","L89310","A498","A4901","M7989","N179","Z933","R509","M8618","S31829A","R338","L89313","R112","R6883","R9431","M869","L89314","Z5889","R000","Z981","S32010A","N3289","Z960","S31809A","D72829","I9589","D649","Z79899","K5900","I959","J328","S22080A","S2231XA","E669","L89319","B952","B9689","B9562","E43","D62","R64","S34109S","S32008S","V892XXS","L89303","S2241XA","J984","S27329A","Z87891","J939","S32028A","M5384","B9561","D509","H5712","R3589","R945","N310","L89300","R350","R7401","N3000","L8990","L8946","S34109A","S32008A","S0501XA","L89309","D6489","S32009A","R2689","S32009S","Z9189","L98419","L89152","L89151","E559","A4189","M8668","M069","F1010","R160","S199XXA","Z48298","S31000A","A419","W050XXA","E861","B965","D638","E871","N99820","J101","M8628","Z48815","I890","Z433","Z435","Z466","Z452","Z792","Z9181","Z23","Z48817","E46","Z6824","T8130XA","M868X8","Z6822","Z8261","Z4803","R339","Z602","Z604","L8943"],"date":["2026-06-15","2026-06-15","2026-04-10","2025-07-09","2025-10-24","2025-07-09","2026-04-24","2026-06-15","2026-06-08","2026-06-08","2025-10-17","2026-06-08","2025-12-03","2025-10-15","2025-10-12","2026-03-18","2026-01-29","2025-10-15","2026-03-20","2026-06-03","2026-04-07","2025-10-15","2025-11-02","2025-11-25","2026-01-05","2025-11-23","2025-11-24","2026-06-15","2026-06-15","2025-12-08","2026-01-13","2025-12-26","2026-01-09","2025-12-26","2025-12-17","2025-12-24","2026-03-06","2026-03-13","2025-02-17","2026-05-08","2026-05-08","2026-05-08","2025-04-08","2025-04-08","2025-04-29","2025-04-29","2026-06-12","2026-04-15","2025-10-13","2026-01-09","2025-10-13","2025-11-02","2026-04-17","2025-11-25","2026-04-17","2026-04-10","2026-02-27","2025-11-28","2025-11-28","2025-11-28","2026-01-13","2026-03-19","2026-01-13","2026-01-05","2026-01-13","2026-06-08","2026-01-04","2026-03-19","2026-01-08","2026-05-07","2026-05-19","2026-02-18","2026-02-18","2026-04-07","2026-03-20","2026-06-11","2026-04-07","2026-04-07","2026-04-07","2026-03-02","2026-03-02","2026-04-01","2026-03-02","2026-04-15","2026-03-02","2026-05-08","2026-05-01","2026-04-17","2026-04-01","2026-03-04","2026-03-18","2026-03-04","2026-03-04","2026-03-20","2026-03-19","2026-03-10","2026-03-10","2026-04-17","2026-04-10","2026-04-17","2026-04-17","2026-03-13","2026-04-10","2026-03-13","2026-03-18","2026-03-13","2026-03-13","2026-03-18","2026-03-13","2026-03-13","2026-03-13","2026-06-12","2026-04-03","2026-04-03","2026-03-27","2026-03-27","2026-04-07","2026-04-01","2026-04-03","2026-04-03","2026-03-27","2026-04-17","2026-04-03","2026-04-07","2026-04-07","2026-04-07","2026-04-06","2026-04-06","2026-04-17","2026-04-06","2026-04-10","2026-04-10","2026-04-07","2026-06-15","2026-04-15","2026-04-17","2026-01-13","2026-06-12","2026-06-03","2026-06-08","2026-06-05","2026-06-05","2026-05-14","2026-06-05","2026-06-05","2026-06-05","2026-01-09","2026-01-09","2026-04-17","2026-01-09","2026-01-09","2026-01-26","2026-02-25","2026-02-27","2026-02-27","2026-04-17","2026-05-08","2026-05-08","2026-02-27","2026-02-27","2026-02-27","2026-04-17","2026-04-17","2026-05-08","2026-04-17","2026-04-07","2026-04-07","2026-04-07","2026-04-07","2026-05-08","2026-05-08","2026-05-08","2026-05-08","2026-06-03"],"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":[["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS","","","Select","Select",""],["","","GABAPENTIN","400 MG","","Select","Select",""],["","","LEVOFLOXACIN","750 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","SANTYL","","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","NITROFURANTOIN MONOHYDRATE","100 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","MORPHINE SULFATE ER","15 MG","","Select","Select",""],["","","DULOXETINE HYDROCHLORIDE DR","60 MG","","Select","Select",""],["","","AMITRIPTYLINE HYDROCHLORIDE","75 MG","","Select","Select",""],["","","SILVER SULFADIAZINE","1%","","Select","Select",""],["","","DULOXETINE HCL","30 MG","","Select","Select",""],["","","GENTAMICIN SULFATE","0.10%","","Select","Select",""],["","","DULOXETINE HYDROCHLORIDE","40 MG","","Select","Select",""],["","","DAPTOMYCIN","500 MG","","Select","Select",""],["","","METHOCARBAMOL","500 MG","","Select","Select",""],["","","CEFEPIME","2 GM","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE ER","10 MG","","Select","Select",""],["","","OXYCODONE HYDROCHLORIDE","20 MG","","Select","Select",""],["","","MIDODRINE HYDROCHLORIDE","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":""}]}]}