{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBBY L RULE","gend":1,"currentgend":"","add":"9254 W 21st North Apt 315","city":"Wichita","state":"KS","zip":"67205","age":"","mstatus":"","insh":"K44011907","cliId":"","pno":"3166332267","cno":"","email":"pugr@ymail.com","ename":"","eno":"","pphy":"GERALD NIERNBERGER","ppno":"3166094501","pcpadd":"14700 W SAINT TERESA ST","pcpcity":"WICHITA","pcpstate":"KS","pcpzip":"67206-2900","pcpcounty":"","pcpid":"","pcpname":"ASCENSION MEDICAL GROUP VIA CHRISTI PA","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"         ","pcpfaxno":"","pcpnpi":"1417986894","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44011907","medicareid":"8E44GN7PH09","medicaidid":"8E44GN7PH09","pcpFlag":"","dob":"1959-05-25"},{"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":["R55","Z950","E119","E785","Z720","Z8249","Z9189","J449","G4700","G2581","I495","R200","F319","R202","J441","F419","F329","R0902","J439","I2510","R109","F331","R32","F411","F5101","R059","Z7901","F17210","Z91048","Z7982","Z7984","Z79899"],"date":["2026-02-16","2026-02-16","2026-05-26","2026-04-21","2026-04-08","2026-02-16","2026-02-16","2026-05-26","2026-02-23","2026-05-26","2026-04-21","2026-02-23","2026-05-26","2026-02-23","2026-04-08","2026-04-08","2026-04-08","2026-04-06","2026-04-20","2026-04-21","2026-05-26","2026-05-26","2026-05-26","2026-06-09","2026-06-09","2026-04-06","2026-04-06","2026-04-06","2026-04-06","2026-04-06","2026-04-06","2026-04-06"],"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":[["","","OXYBUTYNIN CHLORIDE ER","15 MG","","Select","Select",""],["","","ALPRAZOLAM","0.5 MG","","Select","Select",""],["","","RISPERIDONE","2 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","80 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","ROPINIROLE HCL","1 MG","","Select","Select",""],["","","CITALOPRAM HYDROBROMIDE","20 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","JANUVIA","100 MG","","Select","Select",""],["","","LEVALBUTEROL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","SITAGLIPTIN PHOSPHATE","100 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":""}]}]}