{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VERLA F BUCH","gend":1,"currentgend":"","add":"4712 SW 6th St","city":"Topeka","state":"KS","zip":"66606","dob":"1928-12-08","age":"","mstatus":"","insh":"K44010308","cliId":"","pno":"7854784779","cno":"","email":"kenb.pam@gmail.com","ename":"","eno":"","pphy":"SAM HARWOOD","ppno":"7857642087","pcpadd":"1133 SW TOPEKA BLVD","pcpcity":"TOPEKA","pcpstate":"KS","pcpzip":"66047","pcpcounty":"","pcpid":"","pcpname":"COTTON O NEIL","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"Apt 212","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1700254174","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44010308","medicareid":"2XD0HU5VU26","medicaidid":"2XD0HU5VU26","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":["R0789","R519","M79604","M25561","M170","M51361","G8929","M6281","M4726","N135","I10","E7800","Z8673","F329","K5909","R600","Z8739","Z87898","B351","L84","R1114","T887XXA","Z960","N1330","R110","F411","F429","M533","I493","M316","G319","M19011","M7531","H353131","R531","H02401","I491","H01003","H169","S0501XA","M25571","R944","R7402","R7982","R7309","F339","Z8659","H16103","F32A","R609","F419","M19072","M19071","M79605","E785","R918","R509","R0981","R079","R059","D72829","E871","R319","Z872","M5450","M810","K219","L03115","J101","S96911A","M1990","M48061","R5383","J9690","G20C","G309","F0150","M4800","G629","Z8619","G510","Z85828","Z885","Z882","Z888","H44519","R112","Z741","M5416","L03114","S22080A","J189","L0390","R1312","E46","H40059","R2689","J09X1","N130","I252","M25552","K8590","Z87442","Z881","K5730","Z79899","R64","M8580","F4323","Z6822","B91","N390","N179","M25512","S83101A","R82998","I519","E561"],"date":["2025-06-16","2026-04-14","2026-02-18","2025-06-26","2026-03-31","2025-06-26","2026-01-23","2025-04-21","2025-04-21","2026-06-11","2026-05-25","2025-07-07","2025-07-07","2025-07-07","2025-10-15","2026-01-23","2025-07-07","2025-07-07","2025-06-26","2025-06-26","2025-09-23","2025-10-15","2026-06-11","2026-01-23","2025-10-15","2025-10-15","2025-10-15","2025-10-15","2025-10-28","2025-11-21","2025-12-17","2025-12-30","2025-12-30","2025-09-29","2025-04-21","2025-04-21","2025-02-04","2025-02-27","2025-02-27","2025-02-27","2025-04-21","2025-03-14","2025-03-14","2025-03-14","2025-03-26","2025-03-18","2025-03-20","2025-03-12","2026-02-10","2026-02-02","2026-02-10","2025-03-18","2025-03-18","2025-03-16","2026-02-10","2025-03-26","2025-03-26","2025-03-26","2025-03-26","2025-03-26","2025-03-26","2025-03-26","2025-04-01","2025-04-23","2025-04-23","2025-10-28","2026-02-10","2025-04-21","2025-04-14","2025-03-31","2025-03-26","2025-04-21","2025-04-14","2025-04-14","2025-04-14","2025-04-14","2025-04-14","2025-04-09","2025-04-09","2025-04-09","2026-02-10","2026-02-10","2026-02-10","2026-02-10","2026-02-10","2025-08-12","2025-09-17","2026-05-25","2026-05-25","2026-05-25","2026-05-25","2026-05-25","2026-05-25","2026-05-25","2025-04-21","2025-04-21","2025-04-21","2025-03-29","2025-10-15","2025-10-28","2025-10-28","2025-10-28","2025-10-28","2025-10-28","2026-04-14","2026-04-03","2025-03-14","2025-03-14","2025-03-14","2025-03-14","2025-04-28","2025-04-28","2026-01-23","2026-05-19","2026-06-04","2026-02-02","2026-04-03","2026-04-06"],"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":[["","","GABAPENTIN","100 MG","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","10 MEQ","","Select","Select",""],["","","SERTRALINE HYDROCHLORIDE","50 MG","","Select","Select",""],["","","OMEPRAZOLE","40 MG","","Select","Select",""],["","","LOPERAMIDE HYDROCHLORIDE","2 MG","","Select","Select",""],["","","DIVALPROEX SODIUM DR","250 MG","","Select","Select",""],["","","OMEPRAZOLE DR","40 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","ONDANSETRON HYDROCHLORIDE","4 MG","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","CELECOXIB","100 MG","","Select","Select",""],["","","CEFPODOXIME PROXETIL","200 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","LATANOPROST","0.01%","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","12.5 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","NEOMYCIN\/POLYMYXIN\/DEXAMETHASONE","0.10%","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","DORZOLAMIDE HCL\/TIMOLOL MALEATE","","","Select","Select",""],["","","Cephalexin Cap","500 MG","","Select","Select",""],["","","Prednisone Tab","5 MG","","Select","Select",""],["","","Amoxicillin Cap","500 MG","","Select","Select",""],["","","Latanoprost Sol 0.005%","","","Select","Select",""],["","","Sertraline Tab","25 MG","","Select","Select",""],["","","Neo\/Poly\/Dex Sus 0.1% Op","","","Select","Select",""],["","","Divalproex Tab","250 MG","","Select","Select",""],["","","Celecoxib Cap","100 MG","","Select","Select",""],["","","Furosemide Tab","20 MG","","Select","Select",""],["","","Paxlovid Tab 150-100","","","Select","Select",""],["","","Hydroco\/Apap Tab 5-325Mg","","","Select","Select",""],["","","Neo\/Poly\/Dex Oin 0.1% Op","","","Select","Select",""],["","","Cefpodoxime Tab","200 MG","","Select","Select",""],["","","Loperamide Cap","2 MG","","Select","Select",""],["","","Hydrochlorot Tab","12.5 MG","","Select","Select",""],["","","Gabapentin Cap","100 MG","","Select","Select",""],["","","Pot Chloride Cap","10 MEQ","","Select","Select",""],["","","Dorzol\/Timol Sol 2-0.5%Op","","","Select","Select",""],["","","Pot Chloride Tab","10 MEQ","","Select","Select",""],["","","Azithromycin Tab","250 MG","","Select","Select",""],["","","Omeprazole Cap","40 MG","","Select","Select",""],["","","Amox\/K Clav Tab 875-125","","","Select","Select",""],["","","Ondansetron Tab","4 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":""}]}]}