{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"M EITTAMDROBED ","gend":1,"add":"       RIC NISACCOM 20261                         ","city":"ABINGDON                 ","state":"VA","zip":"24210-9998","dob":"1937-09-03","age":"","mstatus":"","insh":"00112174","cliId":"","pno":"2667256968","cno":"","email":"","ename":"","eno":"","pphy":"SUTHERLAND, CLINTON H","ppno":2766284406,"pcpadd":"391 FALLS DR NW,  ","pcpcity":"Abingdon","pcpstate":"VA","pcpzip":242108093,"pcpcounty":"","pcpid":"","pcpname":"WELLMONT MEDICAL ASSOCIATES INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"16202 MOCCASIN CIR                                ","madd2":"                                                  ","madd3":"","mcity":"ABINGDON                 ","mstate":"VA","mzip":"24210-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L57.0","M25.561","Z96.651","I48.0","E78.00","I10","K21.9","E21.3","E55.9","R63.4","G47.09","Z00.00","M16.11","M81.0","E04.1","Z01.818","Z01.812","Z23","M17.11","G89.18","R29.898","D48.5","R53.82","Z47.1","R26.89","M62.81","Z79.82","M25.551","R39.9","I08.3","I27.20","N39.0","R39.15","R35.0","R30.0","H35.3131","H25.813","H31.22","D48.1","R00.0","H34.8320","Z98.890","M79.641","M79.642","K22.70","I65.23","I51.9","I48.91","M17.10","G62.9","Z79.899","Z13.820","D64.9","E87.1","K22.710","R13.14","G89.29","R00.2","E07.9","M19.90","G47.00","Z87.19","R12","K20.9","C44.1122","H02.055","D23.112","F51.01","M16.12","I67.2","G89.4","Z68.1","I51.89"],"date":["2021-06-16","2021-05-21","2021-05-21","2022-03-15","2021-12-27","2022-03-15","2022-02-16","2022-03-01","2022-03-01","2021-09-01","2021-08-25","2021-08-25","2021-07-02","2022-03-01","2021-09-01","2019-03-06","2019-03-06","2020-09-01","2019-06-13","2019-04-26","2019-04-26","2021-06-16","2021-03-01","2019-04-01","2019-04-01","2019-04-01","2020-11-03","2021-06-09","2019-09-27","2021-09-08","2021-09-08","2019-07-31","2019-09-27","2019-09-27","2019-12-04","2021-06-16","2022-06-20","2021-06-16","2021-06-16","2020-08-19","2022-06-20","2020-06-25","2020-06-25","2020-06-25","2022-02-16","2022-03-15","2021-09-28","2020-09-21","2019-03-22","2019-03-22","2020-07-18","2020-09-30","2019-06-04","2021-03-01","2019-02-20","2019-02-25","2019-02-22","2020-07-18","2020-07-18","2020-11-03","2020-07-18","2020-07-18","2018-12-18","2018-12-18","2021-05-28","2021-11-29","2021-06-16","2019-12-04","2021-06-23","2021-09-08","2020-11-03","2020-11-03","2022-03-15"],"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":[["","65862056099","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","68382013510","LOSARTAN","TAB 25MG","30","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","3.5","Select","Select",""],["","50111043301","TRAZODONE","TAB 50MG","30","Select","Select",""],["","49281012165","FLUZONE","INJ 2021-22","0.7","Select","Select",""],["","65162004710","OXYCODONE","TAB 5MG","12","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","21922000909","DICLOFENAC","GEL 0.01","300","Select","Select",""],["","68462018022","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","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":["",""]}},{"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":""}]}]}