{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"M ASSENAVNOTELDDI","gend":1,"add":"     EVA NOTGNIHSAW B 313                         ","city":"FRANKLIN                 ","state":"VA","zip":"23851-1552","dob":"1954-12-01","age":"","mstatus":"","insh":"00114453","cliId":"","pno":"6375782474","cno":7573647428,"email":"","ename":"","eno":"","pphy":"GRAVES, NIKKI L","ppno":7574847248,"pcpadd":"2897 BRIDGE ROAD,  STE 11","pcpcity":"SUFFOLK","pcpstate":"VA","pcpzip":234351799,"pcpcounty":"","pcpid":"","pcpname":"NANSEMOND SUFFOLK FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"313 B WASHINGTON AVE                              ","madd2":"                                                  ","madd3":"","mcity":"FRANKLIN                 ","mstate":"VA","mzip":"23851-1552","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M21.611","M79.671","E11.9","H04.123","H18.513","I10","Z68.32","M19.071","R05","U07.1","E87.6","R42","R09.81","Z88.0","M76.62","M25.572","G89.29","M25.511","S43.401A","W01.10XA","Z86.16","E78.5","M25.562","Z79.4","M62.830","T07.XXXA","W01.0XXA","S86.812A","M19.90","S83.92XA","X58.XXXA","M17.12","M19.012","M25.462","Z86.79","M25.512","M75.81","S90.31XA","S80.02XA","W19.XXXA","M17.11","E11.21","Z68.31","S80.12XA","Z00.00","Z71.89","E11.69","Z68.28","Z51.81","R73.03","H18.51","S43.431A","S46.011A","S46.111A","S49.91XA","M19.011","R93.7","M75.21","N30.90","G89.18","M21.6X1","M20.5X1","E03.9","Z79.82","Z98.890","M25.532","E11.65","T50.2X5A","Z12.31","Z68.34","Z85.3","N89.8","L98.9","Z20.2","B37.3","Z23","Z68.30","L73.9","A59.01","Z71.2","Z68.33","H43.391","H43.393"],"date":["2021-01-04","2021-01-04","2022-06-07","2022-01-05","2022-01-05","2022-06-14","2019-12-09","2020-03-09","2021-01-19","2021-01-19","2022-06-14","2021-01-19","2021-01-19","2021-02-10","2019-06-03","2019-02-05","2022-06-14","2021-08-04","2021-02-10","2021-02-10","2021-02-10","2022-06-14","2022-06-14","2022-06-07","2020-02-23","2020-02-23","2020-02-23","2020-02-23","2020-02-23","2020-02-23","2020-02-23","2020-02-27","2020-02-27","2020-02-27","2020-02-27","2020-02-27","2021-04-12","2020-03-09","2020-03-09","2021-03-27","2020-03-09","2020-03-09","2020-03-09","2020-03-09","2022-06-14","2022-06-14","2022-06-14","2021-04-22","2021-06-15","2019-04-26","2019-04-26","2021-03-27","2021-08-19","2021-03-27","2021-03-27","2021-03-27","2021-03-27","2021-04-12","2018-05-10","2018-05-18","2018-05-18","2018-05-18","2018-05-18","2018-05-18","2018-07-18","2019-06-03","2021-07-22","2022-06-14","2021-12-28","2018-09-19","2019-08-26","2020-09-24","2020-09-15","2020-09-24","2020-09-24","2021-10-06","2022-06-14","2020-10-07","2020-10-07","2018-11-05","2018-11-05","2020-12-22","2020-12-30"],"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":[["","29300039810","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","16729018317","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","52817036100","METOPROL","TAB 50MG","30","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","2","Select","Select",""],["","51224010750","METFORMIN","TAB 750MG ER","30","Select","Select",""],["","00006022131","JANUVIA","TAB 25MG","30","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","00378456105","POT  CHLORIDE","TAB 10MEQ ER","30","Select","Select",""],["","60505014101","GLIPIZIDE","TAB 5MG","30","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","100","Select","Select",""],["","68462018022","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","68382005101","MELOXICAM","TAB 15MG","30","Select","Select",""],["","49348089610","SM","PAD PREP","100","Select","Select",""],["","00781502207","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","62332001731","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","12","Select","Select",""],["","67405060301","FLUCONAZOLE","TAB 150MG","3","Select","Select",""],["","23155013525","DOXYCYC","TAB 100MG","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":["",""],"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":""}]}]}