{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LAWANDA AARNES","gend":1,"currentgend":"","add":"7101 SW 69th Street","city":"AUBURN","state":"KS","zip":"66402","dob":"1940-08-22","age":"","mstatus":"","insh":"K44009869","cliId":"","pno":"7853836356","cno":"","email":"Kyle.D.Aarnes@ssa.gov","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"7101 SW 69th Street","madd2":"","madd3":"","mcity":"Auburn","mstate":"KS","mzip":"66402","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44009869","medicareid":"2EV3MA0AR98","medicaidid":"2EV3MA0AR98","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":["B351","L603","L84","L03116","L03115","F03B4","E1140","N3946","Z794","Z7984","R531","I509","E119","E7849","I10","R600","M8588","M7989","M8580","S79911A","M1611","M8589","S99912A","M85872","M1612","Z043","M25572","R944","R7401","R82998","W01198A","Y929","W0110XA","M79605","R208","F03B3","F32A","M810","Z556","Z7982","Z791","Z79899","L89321","E46","R32","Z7409","M25551","L89322","R5381","N390","R0989","M5416","F329","F419","F639","F411","Z96641","M542","S199XXA","S0990XA","G8911","Z7901","W1830XA","R4182","I447","R000","R9431","G3184","I890","F332","D473","R451","D696","N1831","E1122","F330","N170","E1165","F03918","F0393","B952","L89311","E875","K5900","L89312","Z20822","G4700","Z66","M79651","N1830","Z8673","Z880","Z881","Z888","Z9181","N179","F0394","Z993","R4189","G44309","G8929","M160","Z741","M6281","R262","M1990","R41841","E860","Z593"],"date":["2025-10-01","2025-10-01","2025-10-01","2025-10-01","2025-10-01","2025-10-30","2025-11-20","2025-11-24","2026-01-24","2026-03-14","2025-03-14","2026-02-01","2026-03-14","2025-12-15","2026-03-14","2026-01-25","2025-12-03","2025-01-25","2026-02-01","2025-01-25","2026-02-01","2025-01-25","2025-01-25","2025-01-25","2025-01-25","2025-01-25","2025-01-25","2025-01-25","2025-01-25","2025-01-25","2025-01-25","2025-01-25","2025-01-25","2025-03-20","2025-03-20","2025-07-14","2025-07-14","2025-07-14","2025-07-14","2026-03-14","2025-07-14","2026-03-14","2026-01-14","2026-02-01","2026-02-01","2026-02-01","2026-01-24","2026-02-01","2026-01-22","2026-01-26","2026-01-31","2026-02-03","2026-02-03","2026-01-24","2026-02-03","2026-02-03","2026-03-14","2026-03-14","2026-03-14","2026-03-14","2026-03-14","2026-03-14","2026-03-14","2026-01-06","2026-01-07","2026-01-07","2026-01-07","2026-03-05","2026-03-05","2026-04-30","2026-03-05","2026-02-01","2026-03-31","2026-04-30","2026-04-30","2026-01-24","2026-01-24","2026-05-29","2026-02-01","2026-02-01","2026-01-24","2026-01-14","2026-02-01","2026-02-01","2026-02-01","2026-02-01","2026-02-01","2026-02-01","2026-01-24","2026-01-24","2026-02-01","2026-01-24","2026-01-24","2026-01-24","2026-02-01","2026-02-01","2026-02-01","2026-02-01","2026-03-14","2026-03-14","2026-03-14","2026-03-14","2026-05-29","2026-05-29","2026-05-29","2026-05-29","2026-05-29","2026-01-08","2026-01-08"],"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":[["","","ALBUTEROL SULFATE","0.08%","","Select","Select",""],["","","HYDROXYUREA","500 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40 MG","","Select","Select",""],["","","FUROSEMIDE","80 MG","","Select","Select",""],["","","TRAZODONE HYDROCHLORIDE","50 MG","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","5 MG","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","ELIQUIS","2.5 MG","","Select","Select",""],["","","BUSPIRONE HYDROCHLORIDE","10 MG","","Select","Select",""],["","","QUETIAPINE FUMARATE","25 MG","","Select","Select",""],["","","MIRTAZAPINE","15 MG","","Select","Select",""],["","","CELECOXIB","100 MG","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","METOPROLOL SUCCINATE ER","25 MG","","Select","Select",""],["","","RIVASTIGMINE TRANSDERMAL SYSTEM","4.6 MG","","Select","Select",""],["","","PRIMIDONE","50 MG","","Select","Select",""],["","","SERTRALINE HYDROCHLORIDE","100 MG","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE ER","500 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","10 MEQ","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","LORAZEPAM","0.5 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","NYAMYC","","","Select","Select",""],["","","NITROFURANTOIN MONOHYDRATE\/MACROCRYSTALS","100 MG","","Select","Select",""],["","","METOLAZONE","2.5 MG","","Select","Select",""],["","","Mirtazapine Tab","7.5 MG","","Select","Select",""],["","","Metolazone Tab","2.5 MG","","Select","Select",""],["","","Albuterol Neb 0.083%","","","Select","Select",""],["","","Furosemide Tab","80 MG","","Select","Select",""],["","","Eliquis Tab","2.5 MG","","Select","Select",""],["","","Rivastigmine Dis","4.6 MG","","Select","Select",""],["","","Cyclobenzapr Tab","5 MG","","Select","Select",""],["","","Nyamyc Pow 100000","","","Select","Select",""],["","","Nystatin Pow 100000","","","Select","Select",""],["","","Pot Chloride Tab","20 MEQ","","Select","Select",""],["","","Hydroxyurea Cap","500 MG","","Select","Select",""],["","","Pot Cl Micro Tab","20 MEQ","","Select","Select",""],["","","Celecoxib Cap","100 MG","","Select","Select",""],["","","Metformin Tab","500 MG","","Select","Select",""],["","","Novolog Inj Flexpen","","","Select","Select",""],["","","Sertraline Tab","100 MG","","Select","Select",""],["","","Lantus Solos Inj 100\/Ml","","","Select","Select",""],["","","Gabapentin Cap","300 MG","","Select","Select",""],["","","Hydroco\/Apap Tab 5-325Mg","","","Select","Select",""],["","","Quetiapine Tab","25 MG","","Select","Select",""],["","","Metoprol Suc Tab","25 MG","","Select","Select",""],["","","Primidone Tab","50 MG","","Select","Select",""],["","","Buspirone Tab","5 MG","","Select","Select",""],["","","Rivastigmine Dis 13.3\/24","","","Select","Select",""],["","","Pot Chloride Cap","10 MEQ","","Select","Select",""],["","","Pantoprazole Tab","40 MG","","Select","Select",""],["","","Lorazepam Tab","0.5 MG","","Select","Select",""],["","","Trazodone Tab","50 MG","","Select","Select",""],["","","Nitrofurantn Cap","100 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":""}]}]}