{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"T LIRPAREKCUT ","gend":1,"add":"               TS KAO 107                         ","city":"BLACKSTONE               ","state":"VA","zip":"23824-9998","dob":"1984-04-25","age":"","mstatus":"","insh":"00110493","cliId":"","pno":"9243458332","cno":4342644247,"email":"","ename":"","eno":"","pphy":"MANDEVILLE, JOHN DAVID","ppno":4343928177,"pcpadd":"833 BUFFALO ST STE 200,","pcpcity":"Farmville","pcpstate":"VA","pcpzip":239011111,"pcpcounty":"","pcpid":"","pcpname":"CVHS FARMVILLE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"701 OAK ST                                        ","madd2":"                                                  ","madd3":"","mcity":"BLACKSTONE               ","mstate":"VA","mzip":"23824-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R33.9","N31.9","R39.81","R32","N20.0","N39.44","N39.0","N39.41","R82.90","Z76.89","Z11.59","R00.2","R82.998","Z82.49","Z23","Z71.9","Z71.89","Z71.3","L98.9","M25.473","N21.0"," "],"date":["2022-10-22","2022-10-22","2022-10-31","2019-09-19","2020-03-09","2022-07-19","2022-07-19","2019-03-14","2018-07-19","2021-12-09","2020-10-30","2021-12-01","2021-12-09","2021-12-09","2021-12-09","2021-12-09","2021-12-20","2021-12-20","2021-12-20","2021-12-20","2022-07-19","2022-10-31"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","68180012101","CEPHALEXIN","CAP 250MG","30","Select","Select",""],["","00469260230","MYRBETRIQ","TAB 50MG","30","Select","Select",""],["","65862070060","CEFUROXIME","TAB 500MG","14","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and 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":[]},{"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":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"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":""}]}]}