{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROSS J PRITCHARD","gend":0,"currentgend":"","add":"2142 N 300th Road","city":"Wellsville","state":"KS","zip":"66092","dob":"1958-09-17","age":"","mstatus":"","insh":"K44010647","cliId":"","pno":"9133026910","cno":"","email":"rjpritchardjr@gmail.com","ename":"","eno":"","pphy":"KEVIN HUGHES","ppno":"7855055404","pcpadd":"406 AMES ST","pcpcity":"BALDWIN CITY","pcpstate":"KS","pcpzip":"66006-3099","pcpcounty":"","pcpid":"","pcpname":"LMH HEALTH PRIMARY CARE-BALDWIN CITY","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"7855055270","pcpnpi":"1538147772","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44010647","medicareid":"3Y43WW5VT77","medicaidid":"3Y43WW5VT77","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":["Z23","Z7689","E7849","E8352","I10","R945","Z2239","E785","R160","Z7984","Z7985","Z87891","Z125","M7711"],"date":["2025-10-23","2026-04-02","2025-10-23","2025-10-23","2026-04-02","2025-10-23","2025-10-23","2026-04-02","2025-03-31","2025-03-31","2025-03-31","2025-03-31","2025-10-23","2026-04-02"],"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":[["","","MELOXICAM","15 MG","","Select","Select",""],["","","OZEMPIC","4 MG","","Select","Select",""],["","","JARDIANCE","25 MG","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE","1000 MG","","Select","Select",""],["","","AMLODIPINE BESYLATE","5 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","10 MG","","Select","Select",""],["","","LISINOPRIL","40 MG","","Select","Select",""],["","","METOPROLOL SUCCINATE ER","100 MG","","Select","Select",""],["","","AZELASTINE HYDROCHLORIDE","0.10%","","Select","Select",""],["","","SHINGRIX","50\/0.5 ML","","Select","Select",""],["","","Jardiance Tab","25 MG","","Select","Select",""],["","","Metoprol Suc Tab","100 MG","","Select","Select",""],["","","Shingrix Inj","50\/0.5 ML","","Select","Select",""],["","","Lisinopril Tab","40 MG","","Select","Select",""],["","","Ozempic Inj","4 MG","","Select","Select",""],["","","Metformin Tab","1000 MG","","Select","Select",""],["","","Amlodipine Tab","5 MG","","Select","Select",""],["","","Atorvastatin Tab","10 MG","","Select","Select",""],["","","Azelastine Spr 0.1%","","","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":""}]}]}