{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"FEJ DRAWDERS NOSREF","gend":0,"add":"ATNOM 4122WN DAOR KU","city":"ROANOKE","state":"VA","zip":"24017-1225","dob":"1947-10-11","age":"","mstatus":"","insh":"00115710","cliId":"","pno":"9240820445","cno":"","email":"","ename":"","eno":"","pphy":"PARK, HYO KWON","ppno":8044693731,"pcpadd":"8631 Namozine Rd, ","pcpcity":"Amelia Court House","pcpstate":"VA","pcpzip":230023410,"pcpcounty":"","pcpid":"","pcpname":"DINWIDDIE MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"N","ano":"","add2":"APT 3","add3":"","madd1":"2214 MONTAUK ROAD NW","madd2":"APT 3","madd3":"","mcity":"ROANOKE","mstate":"VA","mzip":"24017-1225","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","Z74.3","Z91.14","Z87.891","R94.31","S22.32XA","R07.81","R07.89","W07.XXXA","R07.9","W19.XXXA","R05","T14.90XA","M54.2","R41.82","S06.9X1A","S09.90XA","W01.198A","Y93.89","Y92.9","F10.20","S06.9X9A","Z04.3","F10.10","F10.120","R10.32","F10.229","R31.9","R30.0","Y90.0","M25.532","E78.2","M79.642","S63.502A","S63.92XA","G89.11","M10.9","I16.0","I63.9","I69.354","Z79.899","R29.701","Z72.0","T46.5X6A","I69.392","Z91.120","Z82.49","I67.9","I16.1","R29.810","R29.898","R53.1","I51.7","G45.9","R29.818","Z79.82","Z79.02","E83.51","Z28.21","E55.9","G40.901","N17.9","D72.829","G93.40","G93.41","G40.319","I63.512","Y84.8","J96.00","Z66","G81.91","J95.851","I11.9","R29.700","B96.1","I67.82","R90.89","R56.9","Z13.89","M47.816","Z99.11","Z46.82","I08.0","R90.82","Z86.73","A41.9","R65.20","J15.0"],"date":["2022-03-13","2021-05-06","2021-04-23","2021-05-06","2021-04-23","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2020-08-03","2022-03-10","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2018-08-11","2018-08-11","2018-08-11","2018-08-11","2018-08-11","2018-08-11","2018-08-11","2018-09-05","2018-08-31","2018-09-05","2018-09-05","2018-09-05","2018-09-05","2018-10-16","2020-11-14","2022-03-13","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2020-11-14","2020-11-12","2020-11-14","2020-11-13","2020-11-21","2020-11-21","2018-01-10","2018-01-10","2018-01-10","2022-03-10","2022-03-03","2022-03-03","2022-03-05","2022-03-13","2022-03-13","2022-03-03","2022-03-03","2022-03-13","2022-03-03","2022-03-03","2022-03-03","2022-03-03","2022-03-03","2022-03-03","2022-03-10","2022-03-03","2022-03-04","2022-03-03","2022-03-03","2022-03-13","2022-03-10","2022-03-05","2022-03-05","2022-03-10","2022-03-13","2022-03-13","2022-03-13"],"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":[["","68180051703","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","21","Select","Select",""],["","31722054201","INDOMETHACIN","CAP 25MG","30","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","76385011150","CARVEDILOL","TAB 6.25MG","60","Select","Select",""],["","23155000301","HYDRALAZINE","TAB 50MG","90","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":""}]}]}