{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" A CIREDRAWOH","gend":0,"add":"ADNROHT 6275B TPA NL EL","city":"RICHMOND","state":"VA","zip":"23225-9998","dob":"1966-07-13","age":"","mstatus":"","insh":"00110986","cliId":"","pno":"7240809667","cno":"8043047106","email":"","ename":"","eno":"","pphy":"BRYAN, DAPHNE L","ppno":"8042874550          ","pcpadd":"4730 N Southside Plaza, ","pcpcity":"4730 N Southside Plaza,","pcpstate":"VA","pcpzip":"232241742","pcpcounty":"","pcpid":"","pcpname":"VCUHS HAYES E WILLIS HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"5726 THORNDALE LN APT B","madd2":"","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23225-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R93.7","M20.41","M77.31","Z98.890","Z98.1","T84.84XA","M20.11","M77.41","M89.9","T84.293A","Y79.2","I10","G47.33","E66.01","Z68.41","F17.290","M79.89","R69","Z91.14","Z79.899","K77","Z00.00","Z11.59","B19.20","R76.8","F17.210","R21","M25.569","B18.2","E78.5","M17.0","G62.9","M19.071","R60.0","K76.89","M25.571","M25.572","G89.29","E88.81","Z23","R09.81","R05.9","Z20.822","K74.01","K76.0"],"date":["2022-01-20","2022-01-20","2022-01-20","2022-02-15","2022-01-20","2022-02-04","2022-01-20","2022-01-20","2022-02-04","2022-02-04","2022-02-04","2022-03-03","2022-02-04","2022-02-04","2022-02-04","2022-02-04","2022-02-15","2021-10-01","2021-06-08","2021-07-14","2021-06-08","2021-06-08","2021-06-21","2021-09-27","2021-06-16","2021-07-14","2021-07-14","2021-07-14","2022-02-11","2021-07-14","2021-07-20","2021-08-04","2021-08-04","2021-08-04","2021-08-25","2021-09-09","2021-09-09","2021-09-09","2021-09-27","2022-02-11","2021-12-25","2021-12-25","2021-12-25","2022-02-11","2022-02-11"],"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":[["","12496120803","SUBOXONE","MIS 8-2MG","30.00","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","28.00","Select","Select",""],["","65162010250","GABAPENTIN","CAP 300MG","90.00","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","3.00","Select","Select",""],["","29300013601","CLONIDINE","TAB 0.2MG","60.00","Select","Select",""],["","00378395205","ATORVASTATIN","TAB 40MG","90.00","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90.00","Select","Select",""],["","51672128202","TRIAMCINOLON","CRE 0.001","60.00","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","40.00","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","20.00","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}