{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"IL EDYLCRJ DRALL","gend":0,"add":"H noskcaJ llawenotS 85101                 7 tpA yw","city":"Front Royal              ","state":"VA","zip":"22630-5148","dob":"1940-05-11","age":"","mstatus":"","insh":"00110785","cliId":"","pno":"3604549516","cno":"","email":"","ename":"","eno":"","pphy":"GONDY, GAUTHAMI","ppno":5406366131,"pcpadd":"315 WEST 10TH STREET,  ","pcpcity":"FRONT ROYAL","pcpstate":"VA","pcpzip":226302807,"pcpcounty":"","pcpid":"","pcpname":"FRONT ROYAL INTERNAL MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"10158 STONEWALL JACKSON HWY                       ","madd2":"UNIT 7                                            ","madd3":"","mcity":"FRONT ROYAL              ","mstate":"VA","mzip":"22630-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["B35.1","E11.40","E11.51","M79.674","M79.675","Z23","I10","E78.2","E11.29","J44.9","E53.8","R71.8","R25.1","Z12.11","D75.89","R68.89"],"date":["2022-06-16","2022-06-16","2021-11-09","2020-07-09","2020-07-09","2021-11-29","2022-05-31","2022-05-31","2022-05-31","2022-05-31","2022-07-06","2022-05-31","2022-05-31","2022-05-31","2021-11-30","2021-11-30"],"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":[["","23155010210","METFORMIN","TAB 500MG","120","Select","Select",""],["","16714068403","SIMVASTATIN","TAB 40MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","00193658621","MICROLET","MIS LANCETS","100","Select","Select",""],["","00173087310","INCRUSE","INH 62.5MCG","90","Select","Select",""],["","00193731221","CONTOUR","TES NEXT","50","Select","Select",""],["","68180051703","LISINOPRIL","TAB 40MG","90","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","56151014260","TRUPLUS","MIS 28G","200","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":""}]}]}