{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ENIREHTAKLLEWODCM ","gend":1,"add":"TSAC 531ENAL EL","city":"EMPORIA","state":"VA","zip":"23847-9998","dob":"1950-08-02","age":"","mstatus":"","insh":"00110852","cliId":"","pno":"3643427214","cno":"","email":"","ename":"","eno":"","pphy":"ZAW, KYAW THUYA","ppno":4343484400,"pcpadd":"511A Belfield Dr, ","pcpcity":"Emporia","pcpstate":"VA","pcpzip":238471217,"pcpcounty":"","pcpid":"","pcpname":"EMPORIA MANOR LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"135 CASTLE LANE","madd2":"","madd3":"","mcity":"EMPORIA","mstate":"VA","mzip":"23847-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","R39.81","R60.9","M79.89","I10","E66.01","Z68.43","Z79.4","E78.5","F32.9","G89.29","I70.90","Z72.0","Z79.82","J20.9","R06.2","R05","Z79.899","Z87.891","Z82.49","Z83.3","E78.00","E11.59","M79.672","M77.32","M79.675","I51.7","R06.02","R60.0","M79.3","K59.00","R18.8","E87.5","R53.83","H81.10","R07.9","N39.0","R53.1","R94.31","I12.9","I50.9","R35.0","R42","Z79.84","I11.9","E55.9","E83.41","D51.9","R79.9","L60.0","M05.9","R19.5","R82.90","R80.9","J00","R52","J41.1","M17.12","Z78.0","Z13.820","K42.9","R10.31","S76.011A","R10.9","Z12.31","R01.1","E66.3","M25.561","M25.562","Z20.828","I83.893","M79.604","M79.605","R07.89","F17.290","F17.200","L02.92","M79.674","B35.3","R26.89"],"date":["2022-02-20","2022-01-21","2021-10-19","2021-09-20","2021-12-07","2019-09-27","2019-09-27","2019-09-27","2020-11-17","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2019-09-27","2020-11-17","2019-09-27","2019-09-27","2019-09-27","2021-12-07","2021-11-24","2019-02-06","2018-10-16","2020-08-12","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-10-20","2021-10-20","2019-10-21","2020-10-27","2020-12-01","2020-11-17","2020-10-27","2020-10-27","2020-10-27","2021-11-02","2021-11-02","2020-11-09","2020-11-17","2020-11-17","2021-11-18","2021-12-07","2021-12-07","2021-12-07","2021-12-07","2019-12-14","2018-06-18","2020-04-27","2019-04-23","2020-04-27","2019-05-07","2019-05-07","2019-05-07","2018-06-04","2020-07-13","2020-07-13","2018-06-21","2018-06-21","2018-06-21","2018-06-21","2018-07-23","2021-09-09","2021-08-13","2019-08-14","2019-08-14","2020-08-14","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-09-09","2018-01-13","2021-01-13","2021-01-13","2020-02-19","2020-02-18"],"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":[["","43547040211","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","00378623305","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","60505014101","GLIPIZIDE","TAB 5MG","60","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","60","Select","Select",""],["","23155010405","METFORMIN","TAB 1000MG","60","Select","Select",""],["","81131013835","INSULIN","MIS 1ML\/31G","60","Select","Select",""],["","29300039810","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","60505017007","PRAVASTATIN","TAB 40MG","30","Select","Select",""],["","49281040565","FLUZONE","INJ PF 19-20","0.5","Select","Select",""],["","00169183711","NOVOLIN","INJ 70\/30","50","Select","Select",""],["","68645055354","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","68645057854","LOSARTAN","TAB 50MG","90","Select","Select",""],["","99073011001","FREESTYLE    KIT SYSTEM","KIT SYSTEM","1","Select","Select",""],["","99073070914","FREESTYLE    KIT FREEDOM","KIT FREEDOM","1","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","60","Select","Select",""],["","00169183702","NOVOLIN70\/30","INJ RELION","30","Select","Select",""],["","45802005911","NYSTATIN","CRE 100000","30","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","14","Select","Select",""],["","99073070822","FREESTYLE    TES LITE","TES LITE","50","Select","Select",""],["","00168025815","CLOTRIM\/BETA","CRE DIPROP","15","Select","Select",""],["","70461012003","FLUAD","INJ 0.5ML","0.5","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","MIS LANCETS","100","Select","Select",""],["","99073070805","FREESTYLE    MIS LITE","MIS LITE","1","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","28","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","30","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","68180012101","CEPHALEXIN","CAP 250MG","21","Select","Select",""],["","55111015430","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","68382032010","POT  CHLORIDE","TAB 10MEQ ER","15","Select","Select",""],["","00005197102","PREVNAR","INJ ","0.5","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":""}]}]}