{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ASAERHTEDOOG J","gend":1,"add":"SERG 526TS ETTES","city":"PETERSBURG               ","state":"VA","zip":"23803-9998","dob":"1944-02-04","age":"","mstatus":"","insh":"00112624","cliId":"","pno":"9440831750","cno":8044905260,"email":"","ename":"","eno":"","pphy":"KING, TONY ROOSEVELT","ppno":8042304913,"pcpadd":"1606 HULL ST,","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232243806,"pcpcounty":"","pcpid":"","pcpname":"CHARLES CITY MEDICAL GROUP","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"625 GRESSETTE ST","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":["I10","R60.9","N18.3","D64.9","N17.9","R51","E43","G93.41","N39.0","J81.1","Z68.1","E86.0","R41.0","D50.9","D63.8","F03.90","E87.6","I50.9","R26.9","J81.0","F33.1","R53.1","B96.20","I12.9","N18.9","D63.1","F17.210","M62.81","Q82.8","L60.0","B35.3","B35.1","F17.200","Z13.31","Z91.81","Z51.81","Z71.89","Z71.9","Z13.9","R63.0","R63.4","R71.0","K64.1","K29.70","K31.89","E11.22","Q27.33","K64.8","I73.9","Z13.29","Z13.1","Z68.20","L60.2","K21.9","Z13.89","Z12.39","Z12.11","Z13.39","R41.82"],"date":["2022-06-28","2020-02-11","2020-02-11","2020-03-03","2020-02-24","2020-02-24","2020-02-23","2020-02-21","2020-02-28","2020-02-21","2020-03-03","2020-02-28","2020-02-21","2020-02-21","2020-02-21","2020-02-28","2020-02-25","2020-02-22","2020-02-22","2020-02-24","2020-02-24","2020-02-25","2020-02-28","2020-02-28","2020-02-28","2020-02-28","2022-06-28","2020-02-28","2022-08-30","2022-08-30","2022-08-30","2022-08-30","2019-09-23","2020-12-01","2022-06-28","2020-12-01","2020-12-01","2020-12-01","2019-06-25","2018-11-26","2018-09-19","2018-08-23","2018-08-23","2018-09-19","2018-08-23","2018-08-23","2018-09-19","2018-09-19","2022-05-24","2019-11-25","2019-11-25","2019-11-25","2019-11-25","2018-11-26","2020-12-01","2022-06-28","2022-06-28","2022-06-28","2022-09-27"],"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":[["","23155000201","HYDRALAZINE","TAB 25MG","180","Select","Select",""],["","68382097001","CHLORTHALID","TAB 25MG","90","Select","Select",""],["","70436015301","POT  CHLORIDE","TAB 20MEQ ER","90","Select","Select",""],["","47781055201","LABETALOL","TAB 100MG","180","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","14","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":""}]}]}