{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RACHEL D WITTER","gend":1,"currentgend":"","add":"2211 W MCCOY ST","city":"WICHITA","state":"KS","zip":"67203","dob":"1982-03-02","age":"","mstatus":"","insh":"K44010912","cliId":"","pno":"3167068076","cno":"","email":"rdwitter82@gmail.com","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","plan":"BCBSKS","program":"Medicare","lob":"006","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"2211 W MCCOY ST","madd2":"","madd3":"","mcity":"WICHITA","mstate":"KS","mzip":"67203","pcpfaxno":"","pcpnpi":1275356180,"currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44010912","medicareid":"6W43YA4KR86","medicaidid":"1QV3VH3TC16","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F259","F4312","G259","Z62810","Z62811","G629","M79672","L84","F1920","Z89411","Z89431","M79671","F411","Z743","F1520","F1110","J029","M5450","F17210","G8929","G4701","Z7182","Z713","Z6834","L309","J342","J343","Z8669","E0789","R1312","H9042","M26623","E66811","Z0289","J302","J0100","H9202","H9201","Z6830","F410","E663","Z6828","Z880","Z89429","Z887","B49","Z888","Z89421","I10","Z5900","Z79891","H6693","J00","Z89422","Z6832","R1310","Z91198","F28","M7989","F29","F22","F1590","Z79899","F39","Z5982","F250","F15929","F419","T33822A","Z765","Z6827"],"date":["2026-01-23","2026-01-30","2025-06-26","2025-06-26","2025-06-26","2025-09-08","2026-05-07","2026-05-19","2025-08-04","2025-02-04","2025-02-04","2026-01-30","2025-12-03","2025-08-24","2026-05-12","2025-07-28","2025-04-27","2025-04-27","2026-05-19","2026-02-20","2026-01-30","2026-05-19","2026-05-19","2025-03-06","2025-02-13","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-12-19","2025-02-27","2025-02-27","2025-03-18","2025-03-25","2025-04-17","2025-09-16","2025-04-03","2026-05-19","2025-08-21","2026-05-07","2025-10-24","2025-08-09","2025-08-21","2026-05-07","2025-10-24","2025-09-08","2025-09-08","2025-09-08","2025-09-30","2025-09-30","2025-10-24","2025-12-19","2025-03-07","2025-04-03","2026-01-17","2026-01-05","2026-05-07","2026-05-07","2026-01-23","2026-05-07","2026-02-16","2026-02-20","2026-05-07","2026-05-07","2026-05-07","2026-05-19","2026-05-19","2026-05-19"],"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":[["","","CHLORHEXIDINE GLUCONATE","0.12%","","Select","Select",""],["","","HYDROXYZINE HYDROCHLORIDE","50 MG","","Select","Select",""],["","","INVEGA SUSTENNA","78\/0.5 ML","","Select","Select",""],["","","KETOCONAZOLE","2%","","Select","Select",""],["","","RISPERIDONE","0.5 MG","","Select","Select",""],["","","BENZTROPINE MESYLATE","1 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","TRAMADOL HYDROCHLORIDE","50 MG","","Select","Select",""],["","","NAPROXEN","250 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","INDOMETHACIN","50 MG","","Select","Select",""],["","","BUPRENORPHINE HCL\/NALOXONE HCL","2 MG","","Select","Select",""],["","","ALPRAZOLAM","0.5 MG","","Select","Select",""],["","","ESCITALOPRAM OXALATE","20 MG","","Select","Select",""],["","","FLUTICASONE PROPIONATE","50 MCG","","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","","","Select","Select",""],["","","LIDOCAINE HYDROCHLORIDE VISCOUS","2%","","Select","Select",""],["","","OMEPRAZOLE DR","20 MG","","Select","Select",""],["","","IBUPROFEN","800 MG","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","0.10%","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","ERYTHROMYCIN","5 MG","","Select","Select",""],["","","HYDROXYZINE HCL","50 MG","","Select","Select",""],["","","OLANZAPINE","10 MG","","Select","Select",""],["","","LURASIDONE HYDROCHLORIDE","60 MG","","Select","Select",""],["","","NITROFURANTOIN MONOHYDRATE","100 MG","","Select","Select",""],["","","FLUCONAZOLE","100 MG","","Select","Select",""],["","","HYDROXYZINE PAMOATE","25 MG","","Select","Select",""],["","","MONTELUKAST SODIUM","10 MG","","Select","Select",""],["","","OFLOXACIN","","","Select","Select",""],["","","Indomethacin Cap","50 MG","","Select","Select",""],["","","Benztropine Tab","1 MG","","Select","Select",""],["","","Lidocaine Sol 2% Visc","","","Select","Select",""],["","","Naproxen Tab","250 MG","","Select","Select",""],["","","Invega Sust Inj 234\/1.5","","","Select","Select",""],["","","Triamcinolon Cre 0.1%","","","Select","Select",""],["","","Hydroxyz Pam Cap","25 MG","","Select","Select",""],["","","Hydroxyz Hcl Tab","25 MG","","Select","Select",""],["","","Ofloxacin Dro","0.003","","Select","Select",""],["","","Fluticasone Spr","50 MCG","","Select","Select",""],["","","Doxycycl Hyc Cap","100 MG","","Select","Select",""],["","","Montelukast Tab","10 MG","","Select","Select",""],["","","Alprazolam Tab","0.5 MG","","Select","Select",""],["","","Chlorhex Glu Sol 0.12%","","","Select","Select",""],["","","Doxycycl Hyc Tab","100 MG","","Select","Select",""],["","","Hydroco\/Apap Tab 7.5-325","","","Select","Select",""],["","","Tramadol Hcl Tab","50 MG","","Select","Select",""],["","","Risperidone Tab","1 MG","","Select","Select",""],["","","Lurasidone Tab","60 MG","","Select","Select",""],["","","Hydroco\/Apap Tab 5-325Mg","","","Select","Select",""],["","","Fluconazole Tab","100 MG","","Select","Select",""],["","","Ibuprofen Tab","800 MG","","Select","Select",""],["","","Ketoconazole Cre 2%","","","Select","Select",""],["","","Bupren\/Nalox Sub 8-2Mg","","","Select","Select",""],["","","Invega Sust Inj","78\/0.5 ML","","Select","Select",""],["","","Escitalopram Tab","20 MG","","Select","Select",""],["","","Nitrofurantn Cap","100 MG","","Select","Select",""],["","","Erythromycin Oin","5 MG","","Select","Select",""],["","","Azithromycin Tab","250 MG","","Select","Select",""],["","","Invega Sust Inj 117\/0.75","","","Select","Select",""],["","","Omeprazole Cap","20 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":""}]}]}