{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" HTENNEKRS EEL C","gend":0,"add":"IRPS 231ENAL GN","city":"GLADSTONE","state":"VA","zip":"24553-9998","dob":"1963-12-06","age":"","mstatus":"","insh":"00115120","cliId":"","pno":"4843476571","cno":"","email":"","ename":"","eno":"","pphy":"KATHLEEN D DIPASQUALE SEELIG MD","ppno":8047832505,"pcpadd":"517 W GRACE ST,","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232204911,"pcpcounty":"","pcpid":"","pcpname":"THE DAILY PLANET INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"132 SPRING LANE","madd2":"                                                  ","madd3":"","mcity":"GLADSTONE","mstate":"VA","mzip":"24553-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.40","G89.29","M51.26","E11.69","E66.9","E11.65","Z12.5","Z00.01","Z12.11","I10","M75.82","Z71.3","M25.561","E78.2","Z79.899","R01.1","E55.9","E11.9","H25.13","J30.2","K21.9","M47.816","F11.90","G47.62","R11.0","M17.11","G62.9","Z09","Z87.898","T78.40XD","M54.5","J01.10","Z23","Z13.0","J01.20"],"date":["2020-07-07","2020-02-03","2020-07-07","2022-07-13","2018-02-20","2022-04-20","2019-01-08","2019-01-08","2019-01-08","2022-07-13","2019-02-01","2020-07-07","2021-03-03","2021-06-04","2021-03-03","2021-03-03","2022-04-20","2018-08-06","2018-03-20","2022-07-13","2018-04-09","2018-04-11","2019-04-29","2022-04-20","2021-05-11","2022-07-13","2019-12-02","2019-08-22","2019-08-22","2019-08-22","2018-08-27","2021-09-24","2018-11-02","2019-12-02","2022-04-20"],"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":[["","16714033002","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","99073070822","FREESTYLE    TES LITE","TES LITE","50","Select","Select",""],["","99073070805","FREESTYLE    KIT LITE","KIT LITE","1","Select","Select",""],["","23155010405","METFORMIN","TAB 1000MG","60","Select","Select",""],["","68180052002","LISINOP\/HCTZ","TAB 20-25MG","30","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","MIS LANCETS","100","Select","Select",""],["","55111012205","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","62332020830","AMLOD\/VALSAR","TAB 10-320MG","30","Select","Select",""],["","31722088530","ROSUVASTATIN","TAB 40MG","90","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","57599987705","PRECISION","TES XTRA","100","Select","Select",""],["","00406012405","HYDROCO\/APAP","TAB 7.5-325","120","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","68462025301","ROPINIROLE","TAB 0.25MG","60","Select","Select",""],["","49502010202","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","00054001829","PREDNISONE","TAB 20MG","4","Select","Select",""],["","62332000131","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","65862020399","LOSARTAN","TAB 100MG","90","Select","Select",""],["","57237004105","PENICILLN","TAB 500MG","40","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","14","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}