{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" AIVLYSKNIRF C","gend":1,"add":"         TEERTS HT03  426                         ","city":"NEWPORT NEWS             ","state":"VA","zip":"23607-9998","dob":"1984-12-09","age":"","mstatus":"","insh":"00117958","cliId":"","pno":"9375737599","cno":"","email":"","ename":"","eno":"","pphy":"TOUCHET, BRADLEY JAMES","ppno":7575943800,"pcpadd":"10510 JEFFERSON AVE STE A,","pcpcity":"Newport News","pcpstate":"VA","pcpzip":236013102,"pcpcounty":"","pcpid":"","pcpname":"RIVERSIDE BRENTWOOD MEDICAL CENTER FAMILY MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"N","ano":"","add2":"                                                  ","add3":"","madd1":"624  30TH STREET                                  ","madd2":"                                                  ","madd3":"","mcity":"NEWPORT NEWS             ","mstate":"VA","mzip":"23607-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.9","S40.012A","M25.512","V03.10XA","Y93.01","M25.552","F17.210","S40.022A","S79.912A","S49.92XA","V09.20XA","Y92.414","L30.9","F20.9","S39.012A","Z00.00","V89.2XXA","M54.5","Z71.9","Z79.899","L40.9","L98.9","F25.0","F41.1","F33.0","K59.09","E66.9","Z68.31","Z11.59","M54.2","M54.6","M25.511","F20.0","F33.1","R44.3","Z74.3","T16.2XXA","Z23","F32.9","F17.200","Z11.3","Z12.4","E78.5","Z13.1","Z13.228","J06.9","R05","J02.9","R21","Z79.1","R06.02","F29"," "],"date":["2022-10-19","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-09-10","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2021-01-14","2022-02-23","2021-09-10","2021-02-11","2022-02-09","2021-04-08","2021-04-08","2022-02-23","2020-10-27","2021-04-08","2021-06-11","2020-06-20","2020-06-20","2020-06-20","2020-06-20","2020-06-20","2020-06-20","2020-08-06","2019-09-27","2019-09-27","2019-09-27","2019-09-26","2020-09-10","2021-09-10","2021-09-10","2021-09-10","2019-09-26","2019-09-26","2019-09-26","2020-10-05","2020-10-05","2019-10-11","2019-10-11","2019-10-11","2020-10-27","2020-10-27","2020-10-27","2020-10-27","2020-10-27","2020-10-27","2020-12-17","2022-10-19"],"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":[["","50458030711","RISPERDAL","INJ 37.5MG","1","Select","Select",""],["","13668013705","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","00228212750","CLONIDINE","TAB 0.1MG","30","Select","Select",""],["","00713075937","BETAMETH","CRE 0.0005","45","Select","Select",""],["","65162019010","NAPROXEN","TAB 500MG","28","Select","Select",""],["","70700010916","CLOBETASOL","CRE 0.0005","60.00","Select","Select",""],["","45802005535","TRIAMCINOLON","OIN 0.001","15","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","4","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","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":["",""]}},{"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":""}]}]}