{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID B WEAKLEY","gend":0,"currentgend":"","add":"663 E 582ND RD","city":"LAWRENCE","state":"KS","zip":"66047","dob":"1954-04-17","age":"","mstatus":"","insh":"K44010101","cliId":"","pno":"9136262573","cno":"","email":"dbweakly@ku.edu","ename":"","eno":"","pphy":"STACEY DINES","ppno":"7855422345","pcpadd":"600 E 20TH ST","pcpcity":"EUDORA","pcpstate":"KS","pcpzip":"66025-7801","pcpcounty":"","pcpid":"","pcpname":"LMH HEALTH PRIMARY","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"663 E 582ND RD","madd2":"","madd3":"","mcity":"LAWRENCE","mstate":"KS","mzip":"66047","pcpfaxno":"","pcpnpi":"1609041748","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44010101","medicareid":"3PN6C76QY60","medicaidid":"3PN6C76QY60","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z7689","I2510","I119","R7989","Z79899","I7123","Z87891","J069","M549","R1031","I7143","I10","K219","M1990","E782","I7120","E785","M546","N529","I7140","R079","Z95828"],"date":["2025-10-29","2025-12-18","2025-07-31","2025-07-31","2026-05-05","2025-12-18","2025-12-18","2025-09-11","2025-09-11","2025-09-11","2025-12-18","2025-12-18","2025-12-18","2025-12-18","2025-09-15","2025-09-15","2025-12-18","2026-05-05","2026-05-05","2026-05-05","2026-05-05","2026-02-09"],"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":[["","","ATORVASTATIN CALCIUM","40 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","ONDANSETRON ODT","4 MG","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","10 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","12.5 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","MELOXICAM","15 MG","","Select","Select",""],["","","Hydrochlorot Cap","12.5 MG","","Select","Select",""],["","","Ondansetron Tab","4 MG","","Select","Select",""],["","","Hydroco\/Apap Tab 5-325Mg","","","Select","Select",""],["","","Cyclobenzapr Tab","10 MG","","Select","Select",""],["","","Atorvastatin Tab","40 MG","","Select","Select",""],["","","Azithromycin Tab","250 MG","","Select","Select",""],["","","Meloxicam Tab","15 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":""}]}]}