{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SEROLEDSPPE L ","gend":1,"add":"RPYC E5TC SSE","city":"PETERSBURG","state":"VA","zip":"23803-9998","dob":"1933-08-04","age":"","mstatus":"","insh":"00112961","cliId":"","pno":"8540807606","cno":"","email":"","ename":"","eno":"","pphy":"WEST, TRENEE J","ppno":8047962373,"pcpadd":"12901 BRIGGS ROAD, ","pcpcity":"CHESTER","pcpstate":"VA","pcpzip":238315335,"pcpcounty":"","pcpid":"","pcpname":"SOUTHSIDE PHYSICIANS NETWORK-FAMILY MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"501 PECAN STREET","madd2":"APT A","madd3":"","mcity":"PETERSBURG","mstate":"VA","mzip":"23803-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G12.21","I83.893","Z48.89","E87.6","I10","M79.672","E78.4","N18.9","R92.8","Z71.89","Z71.3","R26.89","Z13.1","Z23","E78.2","Z86.73","R47.01","K21.9","Z91.19","M19.90","F41.9","R63.4","R74.0","I63.9","R47.9","E11.9","E78.5","I50.30","I34.0","I36.1","S72.001A","S72.141A","K80.20","S09.90XA","W19.XXXA","Z04.3","M62.82","N17.9","D72.829","R79.89","R55","W18.30XA","Y92.009","D62","E83.52","I12.9","I44.7","N18.30","Z79.899","Z01.810","R01.1","M25.551","S72.009D","D64.9","R53.83","S72.102A","R13.12","G62.9","R53.1","R26.2","E43","E55.9","Z11.52","F32.9","M17.12","S31.000A","R13.10","M62.81","L89.153","R26.81","F10.129","R10.13","R07.9","R06.02","Y90.8","N28.9","G45.9","S72.141D","L89.322","I69.320","I69.391","I11.9","F33.9","E46","J30.2","K57.90","H53.9","R32","S72.121D","J44.9","Z91.81","G93.40","I69.351","R13.13","R41.89","L89.156","G12.20","M54.2","R20.0","M54.17","M54.12","M84.359S","G89.18","L89.90","I63.50","M84.459A","M25.511","M48.02","M47.812","R47.1","R29.810","M62.50","R25.3","R29.2","M79.89","Z13.31","Z68.1","G98.8","F39","G89.29","M19.011","S01.01XA","W06.XXXA","Z79.82","Z87.891","Z98.1","S01.01XD","E87.0","F32.1","R63.0","Z11.59","J06.0","I77.1","I77.810","N39.0","A49.9","I95.9","R60.0","Z99.3","R22.1","R59.0","R73.09","R49.0","R19.07","R94.5","K76.9","K72.90","Z91.09","R63.6","G51.4","R51.9","R47.89","W01.0XXA","R62.7","R29.6"],"date":["2022-01-21","2018-02-19","2018-01-24","2020-02-18","2021-08-14","2019-01-24","2018-02-19","2021-05-20","2019-04-05","2020-08-26","2020-08-26","2019-07-30","2020-02-18","2021-06-18","2020-02-25","2021-05-20","2021-03-22","2021-07-21","2020-02-18","2018-02-19","2020-02-25","2021-04-19","2019-02-28","2021-05-20","2020-12-08","2020-11-29","2021-07-21","2021-03-22","2021-03-22","2021-03-22","2021-04-22","2021-05-20","2021-07-21","2021-06-18","2021-06-18","2021-06-18","2021-03-22","2021-04-15","2021-03-23","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2021-05-20","2021-03-23","2021-05-05","2021-03-22","2021-05-05","2021-06-18","2021-03-22","2021-03-24","2021-04-15","2021-03-23","2021-07-21","2021-03-23","2021-03-23","2021-05-22","2021-03-24","2021-04-02","2021-05-05","2021-04-19","2021-07-21","2021-04-05","2019-04-05","2019-04-05","2021-04-09","2021-06-10","2021-04-12","2021-05-05","2021-04-19","2019-04-14","2019-04-14","2019-04-14","2019-04-14","2019-04-14","2021-04-19","2020-04-22","2021-09-19","2021-05-22","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-05-04","2021-05-20","2021-07-21","2021-05-05","2021-09-19","2021-07-21","2021-05-05","2021-05-05","2020-05-06","2020-05-06","2020-05-06","2020-05-06","2020-05-06","2021-05-20","2021-05-20","2021-05-20","2021-05-19","2021-05-14","2021-06-10","2021-06-18","2020-05-27","2021-06-04","2021-06-04","2021-06-04","2021-06-04","2021-06-04","2021-06-10","2021-06-10","2021-07-22","2021-06-10","2021-06-10","2021-06-10","2021-06-10","2021-06-18","2021-06-18","2021-06-18","2021-08-14","2021-06-18","2021-06-25","2021-07-22","2021-07-22","2021-07-22","2020-08-10","2020-08-10","2021-08-14","2021-08-14","2021-08-14","2021-08-14","2021-08-14","2021-08-14","2021-08-14","2020-08-26","2018-09-19","2018-09-07","2020-11-17","2018-10-05","2018-10-05","2018-10-05","2018-10-05","2019-10-30","2019-10-30","2020-11-24","2020-11-24","2020-11-24","2020-11-29","2020-12-08","2018-12-27"],"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":[["","43547036209","LOSARTAN","TAB 100MG","90","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","70436000203","POT  CHLORIDE","TAB 10MEQ ER","90","Select","Select",""],["","00093720298","PRAVASTATIN","TAB 40MG","90","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","10","Select","Select",""],["","00173085910","BREO","INH 100-25","60","Select","Select",""],["","59310057922","PROAIR","AER ","17","Select","Select",""],["","70726030301","TIGLUTIK","SUS 50\/10ML","600","Select","Select",""],["","66758016005","KLOR-CON","TAB 10MEQ ER","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","60","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","23155060601","GLYCOPYRROL","TAB 1MG","180","Select","Select",""],["","57664051083","MIRTAZAPINE","TAB 7.5MG","30","Select","Select",""],["","51991083801","CYPROHEPTAD","TAB 4MG","90","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":""}]}]}