{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ENIROLFRETROP ","gend":1,"add":"             NL WED 10911                         ","city":"MIDLOTHIAN               ","state":"VA","zip":"23112-3625","dob":"1938-05-20","age":"","mstatus":"","insh":"00112994","cliId":"","pno":"0540865172","cno":"","email":"","ename":"","eno":"","pphy":"PAINE, MATTHEW S","ppno":8047396142,"pcpadd":"13540 HULL STREET RD,STE B","pcpcity":"Midlothian","pcpstate":"VA","pcpzip":231122107,"pcpcounty":"","pcpid":"","pcpname":"ST FRANCIS FAMILY MEDICINE CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"11901 DEW LN                                      ","madd2":"                                                  ","madd3":"","mcity":"MIDLOTHIAN               ","mstate":"VA","mzip":"23112-3625","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R69","I63.9","R39.81","I69.351","L03.115","Z68.24","R32","N30.00","S49.91XA","G81.90","I69.910","R53.1","M25.571","I10","T14.8XXA","S42.211A","M79.601","W19.XXXA","Y92.89","Y93.89","K59.00","M62.40","M62.838","R60.0","Z99.3","I69.359","I69.328","H52.13","Z97.3","R07.9","G81.11","R26.9","M62.81","Z74.1","Z74.09","Z79.899","Z87.39","R52","S42.201A","S59.901A","W18.39XA","Y92.009","M25.521","K08.409","M24.521","M24.531","M25.50","R53.83","Z86.73","R29.898","Z91.81","M24.50","Z00.00","S42.214A","S09.90XA","M81.0","Z68.23","I69.959","R35.0","M79.89","E78.2","N18.31","H25.042","H25.13","H52.4","I08.0","I50.30","R01.1","I87.2","M21.371"," "],"date":["2021-08-01","2022-12-01","2022-09-26","2022-09-26","2019-10-10","2022-05-24","2020-12-26","2022-05-24","2019-11-25","2020-08-24","2020-08-24","2020-08-24","2019-09-19","2022-05-24","2019-10-10","2019-11-14","2019-11-14","2019-11-14","2019-11-14","2019-11-14","2022-02-18","2020-12-26","2020-12-26","2020-12-26","2020-12-26","2022-05-24","2020-12-26","2020-12-26","2020-12-26","2019-11-14","2020-05-18","2020-05-18","2020-05-18","2021-11-11","2021-11-11","2021-11-11","2021-11-11","2019-11-14","2019-11-14","2019-11-14","2019-11-14","2019-11-14","2019-11-14","2018-11-29","2018-11-29","2018-11-29","2018-11-29","2022-02-18","2022-02-18","2020-04-23","2020-04-23","2022-05-24","2021-05-05","2019-11-25","2019-11-14","2019-10-21","2019-10-21","2020-11-05","2022-05-24","2022-09-06","2022-05-24","2022-05-24","2022-04-06","2022-04-06","2022-04-06","2022-09-06","2022-09-06","2022-09-06","2022-11-21","2022-11-21","2022-12-01"],"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":[["","43547041309","QUINAPRIL","TAB 40MG","90","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","12","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":""}]}]}