{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DONALD L FISHER","gend":0,"currentgend":"","add":"8106 W 34th St N","city":"Wichita","state":"KS","zip":"67205","age":"","mstatus":"","insh":"K44010401","cliId":"","pno":"3162583936","cno":"","email":"","ename":"","eno":"","pphy":"JOHN MAY","ppno":"3167214544","pcpadd":"8200 W CENTRAL AVE","pcpcity":"WICHITA","pcpstate":"KS","pcpzip":"67212-3661","pcpcounty":"","pcpid":"","pcpname":"WEST WICHITA FAMILY PHYSICIANS","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1104054667","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44010401","medicareid":"9FN5F81TT53","medicaidid":"9FN5F81TT53","pcpFlag":"","dob":"1936-09-04"},{"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":["E1151","B351","Z7984","Z8709","K222","I10","E119","I255","I5020","I959","K2930","I951","R001","Z950","L120","Z23","I5023","I25118","J8410","R011","R531","I459","R4589","Z79899","L299","R059","K2960","K449","R1312","R933","L2989","L218","L821","Z7189","Z08","Z85828","J849","I340","Z95810","R195","E8720","R1319","J188","I2510","Z7902","L739","I442","I4439","B356","D6489","M170","L309","L89329","H25812","R0602","I5022","I110","K2090","K2970","E785","Z72820","Z955","K2950","Z888","Z7951","I5042","E1140","I252","Z89432","Z9181","R6520","K810","K8590","K8309","I9589","E806","R7401","R188","L89893","L89622","I4430","D649","Z794","Z7982","R0789","R1310","M130","Z743","R7989","R630","I509","R0609","I214","R4182","I351","R54","I493","I4510","R5383","E46","L89159","J3489","L84","Z883","Z9049","Z9089","J9601","Z681","R634","I080","J670","F419","F32A","K219","Z9981"],"date":["2026-05-21","2026-05-21","2026-05-21","2025-06-29","2026-04-14","2026-05-19","2026-04-14","2026-05-21","2026-05-21","2025-08-22","2025-08-22","2026-04-14","2026-03-04","2025-07-11","2026-04-14","2025-11-26","2026-04-14","2025-07-14","2026-05-19","2025-07-14","2025-07-14","2025-07-14","2026-02-26","2026-04-06","2025-11-25","2025-11-29","2025-07-11","2025-07-11","2025-07-11","2025-07-11","2025-10-29","2025-10-29","2025-10-29","2025-10-29","2025-10-29","2025-10-29","2026-04-14","2026-02-14","2026-02-25","2025-08-01","2025-09-11","2026-04-14","2025-07-10","2026-06-14","2026-04-14","2025-02-13","2026-04-14","2026-02-25","2025-03-03","2025-04-11","2025-04-11","2025-04-24","2025-04-24","2025-05-19","2025-07-11","2026-02-10","2026-04-14","2025-07-11","2025-07-11","2026-02-10","2025-07-11","2026-04-14","2025-08-22","2025-08-22","2025-08-22","2025-09-11","2025-09-11","2026-02-10","2025-09-11","2025-09-11","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2026-05-19","2026-05-21","2025-02-25","2026-01-22","2026-02-12","2026-04-14","2026-02-10","2026-02-10","2026-02-26","2026-02-12","2026-02-14","2026-04-14","2026-02-14","2026-02-14","2026-02-14","2026-02-10","2026-04-14","2026-05-19","2026-05-19","2026-05-19","2026-05-19","2026-05-21","2026-02-10","2026-02-10","2026-02-10","2026-04-14","2026-02-12","2026-04-14","2026-02-12","2026-02-12","2026-04-14","2026-04-14","2026-04-14","2026-04-14"],"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":[["","","TAMSULOSIN HYDROCHLORIDE","0.4 MG","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","MIDODRINE HYDROCHLORIDE","5 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40 MG","","Select","Select",""],["","","JARDIANCE","25 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","10 MEQ","","Select","Select",""],["","","PRASUGREL HYDROCHLORIDE","10 MG","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE","500 MG","","Select","Select",""],["","","SERTRALINE HCL","50 MG","","Select","Select",""],["","","IPRATROPIUM BROMIDE\/ALBUTEROL SULFATE","","","Select","Select",""],["","","VANCOMYCIN HYDROCHLORIDE","125 MG","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","SERTRALINE HYDROCHLORIDE","100 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","NEOMYCIN\/POLYMYXIN\/DEXAMETHASONE","0.10%","","Select","Select",""],["","","ATORVASTATIN CALCIUM","40 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","METOPROLOL SUCCINATE ER","25 MG","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","0.10%","","Select","Select",""],["","","FINASTERIDE","5 MG","","Select","Select",""],["","","LOSARTAN POTASSIUM","25 MG","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","75 MG","","Select","Select",""],["","","NITROGLYCERIN","0.4 MG","","Select","Select",""],["","","LEVEMIR","","","Select","Select",""],["","","NOVOLOG","","","Select","Select",""],["","","MEGESTROL ACETATE","40 MG","","Select","Select",""],["","","ONETOUCH VERIO TEST STRIPS","","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","FUROSEMIDE","40 MG","","Select","Select",""],["","","MIRTAZAPINE","7.5 MG","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","JASCAYD","18 MG","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","ONDANSETRON ODT","4 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","","","Select","Select",""],["","","BUMETANIDE","1 MG","","Select","Select",""],["","","Paxlovid Tab 300-100","","","Select","Select",""],["","","Vancomycin Cap","125 MG","","Select","Select",""],["","","Nitroglycern Sub","0.4 MG","","Select","Select",""],["","","Cephalexin Cap","500 MG","","Select","Select",""],["","","Novolog Inj 100\/Ml","","","Select","Select",""],["","","Levemir Inj","","","Select","Select",""],["","","Oseltamivir Cap","75 MG","","Select","Select",""],["","","Mirtazapine Tab","7.5 MG","","Select","Select",""],["","","Triamcinolon Cre 0.1%","","","Select","Select",""],["","","Doxycycl Hyc Cap","100 MG","","Select","Select",""],["","","Jardiance Tab","25 MG","","Select","Select",""],["","","Ipratropium\/ Sol Albuter","","","Select","Select",""],["","","Midodrine Tab","5 MG","","Select","Select",""],["","","Sertraline Tab","25 MG","","Select","Select",""],["","","Neo\/Poly\/Dex Sus 0.1% Op","","","Select","Select",""],["","","Megestrol Ac Sus","40 MG","","Select","Select",""],["","","Onetouch Tes Verio","","","Select","Select",""],["","","Prasugrel Tab","10 MG","","Select","Select",""],["","","Novolog Inj Flexpen","","","Select","Select",""],["","","Metformin Tab","500 MG","","Select","Select",""],["","","Metoprol Suc Tab","25 MG","","Select","Select",""],["","","Triamcinolon Cre 0.025%","","","Select","Select",""],["","","Prednisone Tab","20 MG","","Select","Select",""],["","","Cefdinir Cap","300 MG","","Select","Select",""],["","","Finasteride Tab","5 MG","","Select","Select",""],["","","Pantoprazole Tab","40 MG","","Select","Select",""],["","","Pot Chloride Tab","10 MEQ","","Select","Select",""],["","","Tamsulosin Cap","0.4 MG","","Select","Select",""],["","","Atorvastatin Tab","40 MG","","Select","Select",""],["","","Azithromycin Tab","250 MG","","Select","Select",""],["","","Losartan Pot Tab","25 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":""}]}]}