{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KATHLEEN T WYNN","gend":1,"currentgend":"","add":"515 N Maize Rd","city":"WICHITA","state":"KS","zip":"67212","age":"","mstatus":"","insh":"K44014867","cliId":"","pno":"3168416444","cno":"","email":"tor_wynn@friends.edu","ename":"","eno":"","pphy":"","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"#6","add3":"","madd1":"1136 N Coachhouse Rd","madd2":"","madd3":"","mcity":"Wichita","mstate":"KS","mzip":"67235","pcpfaxno":"","pcpnpi":"","currentgendcomment":"","pphycomment":"","uniqueid":"M3AK44014867","medicareid":"8EM9A17WW25","medicaidid":"8EM9A17WW25","pcpFlag":"","dob":"1937-06-26"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R519","I2510","R600","M1990","I10","Z0000","F5104","S52602D","M810","Z79891","Z7982","S2232XD","S2242XD","Z9181","R296","G8929","F03B2","Z79899","E039","F0284","G4700","D649","E785","K219","K5900","Z87440","S0003XA","F0390","Z881","Z882","S32049D","F01B11","F39","Z556"],"date":["2026-03-12","2026-06-02","2026-02-03","2026-06-02","2026-06-02","2026-06-02","2026-06-11","2026-06-02","2026-06-02","2026-06-02","2026-06-02","2026-03-17","2026-02-23","2026-03-17","2026-06-02","2026-06-02","2026-06-11","2026-06-11","2026-03-17","2026-03-17","2026-02-23","2026-02-23","2026-03-17","2026-02-23","2026-02-23","2026-02-23","2026-03-12","2026-06-02","2026-06-02","2026-06-02","2026-03-17","2026-03-17","2026-03-17","2026-03-17"],"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":[["","","LORAZEPAM","1 MG","","Select","Select",""],["","","QUETIAPINE FUMARATE","25 MG","","Select","Select",""],["","","SIMVASTATIN","20 MG","","Select","Select",""],["","","LOPERAMIDE HYDROCHLORIDE","2 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","325 MG","","Select","Select",""],["","","NITROFURANTOIN MONOHYDRATE\/MACROCRYSTALS","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":""}]}]}