{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"QNO IRRETWAHSPU EU","gend":1,"add":"022 TPA TEERTS KNAB E 052                         ","city":"PETERSBURG               ","state":"VA","zip":"23803-9998","dob":"1960-07-29","age":"","mstatus":"","insh":"00112163","cliId":"","pno":"6340819248","cno":8049268386,"email":"","ename":"","eno":"","pphy":"AGADA, RAPHAEL I","ppno":8045262816,"pcpadd":"1719 BELLEVUE AVE,","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232273901,"pcpcounty":"","pcpid":"","pcpname":"RIVERSBEND HOSPITALISTS PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"N","ano":"","add2":"                                                  ","add3":"","madd1":"250 E BANK STREET APT 220                         ","madd2":"                                                  ","madd3":"","mcity":"PETERSBURG               ","mstate":"VA","mzip":"23803-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","1",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I16.1","I10","J44.9","Z91.14","J45.901","L20.9","I50.22","R22.43","R06.09","I50.89","Z87.891","J40","R05","R06.02","R06.2","D64.9","Z82.49","Z83.3","E11.9","F32.0","R07.9","J44.1","K59.00","F06.32","H25.813","H18.413","H11.153","H16.143","M54.2","M50.220","V89.2XXA","M54.5","M54.16","S32.028A","M25.531","M79.641","M79.604","S32.029A","Y92.481","M50.93","M51.9","I21.19","I51.7","R06.00","H10.023","H54.0X33","Z91.81","M25.511","F32.9","R03.0","E66.9","H35.033","H25.13","H18.213","S71.112A","M25.562","W01.198A","Y93.01","Y92.096","Z23","S72.112A","W19.XXXA","S71.132A","W18.30XA","S81.012A","I11.0","I50.9","Z79.899"," "],"date":["2021-01-07","2022-06-26","2021-10-14","2021-09-30","2021-02-25","2019-01-08","2021-02-18","2021-01-28","2021-02-04","2021-03-02","2021-02-04","2020-02-15","2020-02-15","2021-03-02","2020-02-15","2020-03-04","2020-03-04","2020-03-04","2021-10-14","2021-02-25","2021-03-02","2020-03-04","2020-03-04","2020-03-09","2020-03-13","2020-03-13","2020-03-13","2020-03-13","2019-04-02","2019-04-02","2019-04-02","2019-04-02","2019-04-02","2019-04-02","2019-04-02","2019-04-02","2019-04-02","2019-04-02","2019-04-02","2019-04-02","2019-04-02","2018-05-05","2018-05-05","2018-05-05","2018-05-10","2018-08-14","2019-06-27","2022-10-05","2018-08-09","2018-08-09","2021-10-14","2018-12-03","2018-12-03","2018-12-03","2022-06-26","2022-06-26","2022-06-26","2022-06-26","2022-06-26","2022-06-26","2022-06-26","2022-10-05","2022-06-26","2022-06-26","2022-06-26","2022-10-05","2022-10-05","2022-10-05","2022-10-05"],"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":[["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","00378827052","ALBUTEROL","NEB 0.00083","225","Select","Select",""],["","00093312501","DICLOXACILL","CAP 500MG","28","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","30","Select","Select",""],["","67877025145","TRIAMCINOLON","CRE 0.001","454","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","120","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","00228212810","CLONIDINE","TAB 0.2MG","180","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","00173088210","BREO","INH 200-25","60","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","90","Select","Select",""],["","50742024890","DILTIAZEM","CAP 120MG ER","90","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","71093014105","METHOCARBAM","TAB 750MG","15","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","60505384901","CELECOXIB","CAP 200MG","20","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}