{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ENILEUQCAJNOSREFFEJ ","gend":1,"add":"    EVA ENYALREBMAHC 5123                         ","city":"RICHMOND                 ","state":"VA","zip":"23227-4826","dob":"1951-06-12","age":"","mstatus":"","insh":"00115940","cliId":"","pno":"9340813337","cno":"","email":"","ename":"","eno":"","pphy":"HUYNH, CHRISTINE","ppno":8048284571,"pcpadd":"417 N 11TH ST,  ","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232985024,"pcpcounty":"","pcpid":"","pcpname":"MCV AMBULATORY CARE CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APT 107                                           ","add3":"","madd1":"3215 CHAMBERLAYNE AVE                             ","madd2":"APT 107                                           ","madd3":"","mcity":"RICHMOND                 ","mstate":"VA","mzip":"23227-4826","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M85.9","M06.9","Z12.11","R14.0","J45.20","Z12.31","H92.03","R09.81","E04.1","J45.909","E01.0","K64.9","M81.0","E55.9","H26.9","K08.409","R41.3","Z68.29","Z79.51","Z79.899","Z87.39","Z97.2","Z97.3","H25.813","Z20.2","R63.5","E78.5","K59.00","Z68.32","Z00.00","E04.9","Z13.820","R59.9","Z01.812","Z20.822","E04.2","Z86.010","D12.0","K57.30","Z98.890","K63.89","K63.5","K52.9","E66.9"],"date":["2020-07-07","2020-07-07","2022-02-03","2022-03-22","2022-02-03","2021-10-25","2019-10-29","2019-10-29","2019-12-06","2019-11-14","2020-12-11","2019-11-14","2019-11-14","2018-04-20","2018-04-20","2018-04-20","2018-04-20","2018-04-20","2018-04-20","2020-12-11","2018-04-20","2018-04-20","2018-04-20","2021-03-08","2022-03-08","2020-12-11","2021-08-10","2021-08-10","2020-12-11","2019-11-14","2021-08-10","2018-04-10","2021-04-08","2021-04-06","2021-04-06","2021-03-23","2019-08-27","2019-08-27","2019-08-27","2019-08-27","2019-08-27","2019-08-27","2019-08-27","2020-12-11"],"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":[["","00173071920","FLOVENT","AER 110MCG","12","Select","Select",""],["","58160082311","SHINGRIX","INJ 50MCG","1","Select","Select",""],["","49281040565","FLUZONE","INJ PF 19-20","0.5","Select","Select",""],["","55111012205","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4,000.00","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","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":""}]}]}