{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" HAROBEDNOSIRRAG","gend":1,"add":"NIK 60301TC EERTSG","city":"N CHESTERFLD","state":"VA","zip":"23236-9998","dob":"1958-08-09","age":"","mstatus":"","insh":"00113943","cliId":"","pno":"1640869787","cno":8049567172,"email":"","ename":"","eno":"","pphy":"PAINE, MATTHEW S","ppno":8047396142,"pcpadd":"13540 HULL STREET RD,","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":"10306 KINGSTREE CT","madd2":"                                                  ","madd3":"","mcity":"N CHESTERFLD","mstate":"VA","mzip":"23236-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F32.9","E03.9","E03.4","Z79.899","B00.1","F43.10","H53.8","Z00.00","M79.7","F34.1","Z68.23","Z68.32","Z20.822"],"date":["2021-03-09","2021-03-09","2021-07-19","2020-11-11","2019-06-25","2020-11-11","2019-06-25","2019-06-25","2020-09-02","2020-09-02","2019-06-25","2021-07-19","2021-12-18"],"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":[["","16729013716","CLONAZEPAM","TAB 1MG","60","Select","Select",""],["","72305007530","EUTHYROX","TAB 75MCG","30","Select","Select",""],["","00781518192","LEVOTHYROXIN","TAB 50MCG","30","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","80","Select","Select",""],["","65862044830","VALACYCLOVIR","TAB 500MG","14","Select","Select",""],["","00378537501","DOXEPIN","CAP 75MG","30","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}