{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"E ANAITNELLA ","gend":1,"add":"lliV ybsoC 06551 43 tpA evA ega","city":"CHESTERFIELD             ","state":"VA","zip":"23832","dob":"1981-01-19","age":"","mstatus":"","insh":"00117987","cliId":"","pno":"4843465801","cno":"","email":"","ename":"","eno":"","pphy":"BERRYMAN, LESLIE A","ppno":2762582600,"pcpadd":"16000 JOHNSTON MEMORIAL DR STE 213,","pcpcity":"Abingdon","pcpstate":"VA","pcpzip":242110001,"pcpcounty":"","pcpid":"","pcpname":"BLUE RIDGE MEDICAL MANAGEMENT CORPORATION","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"15613   WOLFBORO ROAD                             ","madd2":"                                                  ","madd3":"","mcity":"CHESTERFIELD             ","mstate":"VA","mzip":"23832-1534","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H54.8","F79","N39.46","E03.9","E66.01","Z68.43","J44.9","M10.9","M54.2","H55.01","Z79.02","I10","G47.00","Z01.411","Z30.09","Z01.419","Z12.31","M54.9","G89.29","Z13.89","Q12.0","H55.00","R12","E11.9","Z11.59","M54.5","Z00.00","Z23","Z11.1","G47.33","R35.0","Z12.5","F17.200","B39.9","H25.13","N39.41","H61.21","Z13.220","H31.011"," "],"date":["2020-01-20","2020-01-20","2020-01-20","2022-11-04","2021-05-05","2021-05-10","2020-01-20","2021-01-26","2021-01-26","2022-02-23","2021-04-26","2021-04-26","2021-04-26","2021-05-10","2021-05-10","2021-05-10","2021-05-17","2020-06-23","2020-10-07","2020-06-23","2020-07-13","2022-10-18","2020-07-29","2020-07-29","2020-09-12","2020-10-07","2020-11-27","2022-11-04","2020-11-27","2019-12-23","2020-12-31","2020-12-31","2020-12-31","2022-02-23","2022-10-18","2022-12-08","2022-06-05","2022-06-05","2022-10-18","2022-12-08"],"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":[["","70700011985","ESTARYLLA","TAB 0.25-35","84","Select","Select",""],["","65862077685","MILI","TAB 0.25\/35","84","Select","Select",""],["","69238183407","LEVOTHYROXIN","TAB 100MCG","90","Select","Select",""],["","51672130104","AMMONIUM","CRE 0.12","280","Select","Select",""],["","70461031903","FLUCLVX","INJ 2019-20","0.5","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":""}]}]}