{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ENIAMREJROLYAT N","gend":0,"add":"           LIART ENOOB 44                         ","city":"CARTERSVILLE             ","state":"VA","zip":"23027-9998","dob":"1993-11-28","age":"","mstatus":"","insh":"00113428","cliId":"","pno":"3326589438","cno":9195087903,"email":"","ename":"","eno":"","pphy":"CRESS, ALICIA NACPIL","ppno":8042856050,"pcpadd":"3452 ANDERSON HWY STE D,","pcpcity":"Powhatan","pcpstate":"VA","pcpzip":231395845,"pcpcounty":"","pcpid":"","pcpname":"POWHATAN MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"44 BOONE TRAIL                                    ","madd2":"                                                  ","madd3":"","mcity":"CARTERSVILLE             ","mstate":"VA","mzip":"23027-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.9","I10","E66.9","Z68.39","R10.31","R73.9","E66.01","Z68.43","Z79.899","K21.9","R06.02","R94.5","I49.8","R94.31","R07.89","E86.0","Z68.42","F17.210","Z79.82","R10.32","I51.7","I77.810","Z11.52","E78.5","Z23","Z87.891","F17.200","K76.0","R79.89"," ","L60.0","M79.675"],"date":["2022-11-21","2022-11-21","2020-11-25","2020-11-25","2020-01-08","2022-01-26","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-01-26","2019-09-09","2021-09-06","2021-09-06","2020-09-27","2020-09-27","2020-09-27","2020-09-27","2020-09-27","2022-02-25","2021-10-20","2021-10-20","2022-01-30","2021-09-06","2021-09-06","2021-09-06","2020-01-08","2019-09-09","2019-09-09","2022-11-21","2022-10-31","2022-10-31"],"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":[["","00781286810","OMEPRAZOLE","CAP 20MG","180","Select","Select",""],["","68645051054","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","59310058020","PROAIR","AER ","1","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","15","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","63304069201","CLINDAMYCIN","CAP 150MG","36","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","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":""}]}]}