{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMES P KITCHENS","gend":0,"currentgend":"","add":"10405 S 97TH ST W","city":"CLEARWATER","state":"KS","zip":"67026","dob":"1955-12-25","age":"","mstatus":"","insh":"K44010459","cliId":"","pno":"3162088397","cno":"","email":"jimpatkt@gmail.com","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"10405 S 97TH ST W","madd2":"","madd3":"","mcity":"CLEARWATER","mstate":"KS","mzip":"67026","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44010459","medicareid":"1EA6HY4KJ46","medicaidid":"1EA6HY4KJ46","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N1832","E559","E7849","R600","E790","I7389","I5032","N400","I70213","R0683","I2510","E88811","R0989","K5730","K640","K644","K648","E781","M1A9XX0","E119","E782","I129","E038","E88810","H8110"],"date":["2026-03-24","2026-03-24","2026-03-24","2026-03-24","2025-09-23","2026-03-24","2025-10-27","2025-10-27","2025-12-02","2025-10-27","2025-10-27","2025-10-27","2025-12-02","2025-01-28","2025-01-28","2025-01-28","2025-01-28","2025-03-18","2025-03-18","2025-03-06","2026-06-02","2026-03-12","2026-06-02","2026-06-02","2026-06-02"],"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":[["","","FARXIGA","10 MG","","Select","Select",""],["","","ALLOPURINOL","300 MG","","Select","Select",""],["","","TELMISARTAN","80 MG","","Select","Select",""],["","","FENOFIBRATE","145 MG","","Select","Select",""],["","","ALFUZOSIN HCL ER","10 MG","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","20 MG","","Select","Select",""],["","","ATENOLOL","50 MG","","Select","Select",""],["","","ANASTROZOLE","1 MG","","Select","Select",""],["","","DAPAGLIFLOZIN PROPANEDIOL","10 MG","","Select","Select",""],["","","DAPAGLIFLOZIN","10 MG","","Select","Select",""],["","","Atenolol Tab","50 MG","","Select","Select",""],["","","Dapagliflozi Tab","10 MG","","Select","Select",""],["","","Farxiga Tab","10 MG","","Select","Select",""],["","","Telmisartan Tab","80 MG","","Select","Select",""],["","","Anastrozole Tab","1 MG","","Select","Select",""],["","","Alfuzosin Tab","10 MG","","Select","Select",""],["","","Rosuvastatin Tab","20 MG","","Select","Select",""],["","","Allopurinol Tab","300 MG","","Select","Select",""],["","","Fenofibrate Tab","145 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":""}]}]}