{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" B NAILLILTTOCIRRED","gend":1,"add":"        RD TSERCLLIH 1328                         ","city":"RUTHER GLEN              ","state":"VA","zip":"22546-9998","dob":"1951-01-24","age":"","mstatus":"","insh":"00118287","cliId":"","pno":"8640895937","cno":8048789421,"email":"","ename":"","eno":"","pphy":"YOUNG, CHRISTINE M","ppno":8047989208,"pcpadd":"306 ASHCAKE RD STE C,","pcpcity":"Ashland","pcpstate":"VA","pcpzip":230052323,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS INTERNAL MEDICINE OF ASHLAND","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"8231 HILLCREST DR                                 ","madd2":"                                                  ","madd3":"","mcity":"RUTHER GLEN              ","mstate":"VA","mzip":"22546-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.29","I10","E21.0","E11.65","R80.9","E83.42","Z79.4","E04.2","E55.9","E83.52","E04.9","E78.00","Z00.00","Z71.89","Z78.0","Z68.27","Z12.31","R53.1","T79.6XXA","R29.6","Z20.822","E11.9","Z87.891","Z79.82","Z79.899","E66.3","R06.02","E87.5","M62.82","S09.90XA","M81.0","E11.22","I12.9","N18.31","E03.9","I95.1","W06.XXXA","E11.42","E05.90","Z23","R10.2","Z68.26","R26.9","Z13.31","Z01.812","Z79.84"," ","E11.21","E78.5","Z68.29"],"date":["2022-10-11","2022-11-29","2022-07-08","2022-10-21","2022-03-30","2021-07-06","2022-07-08","2022-02-03","2021-06-01","2021-07-16","2021-07-14","2022-10-11","2022-04-01","2019-08-29","2019-08-29","2022-02-03","2022-11-21","2021-01-18","2021-01-18","2021-01-18","2021-12-10","2021-08-27","2021-12-15","2021-12-15","2022-07-08","2021-01-18","2021-01-18","2022-11-29","2021-02-02","2021-01-18","2021-12-15","2021-12-15","2022-07-08","2022-11-29","2021-12-15","2021-01-18","2021-01-18","2020-04-27","2020-03-30","2019-11-25","2021-01-18","2021-09-02","2021-01-21","2020-04-27","2021-12-10","2022-05-23","2022-11-29","2022-11-29","2022-11-29","2022-10-11"],"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":[["","76385012810","METFORMIN","TAB 500MG ER","270","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","55111032201","GLIMEPIRIDE","TAB 4MG","90","Select","Select",""],["","56151146001","TRUE","TES GLUCOSE","100","Select","Select",""],["","65162075410","BENAZEPRIL","TAB 40MG","90","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","6027731","JANUVIA","TAB 100MG","90","Select","Select",""],["","70461012003","FLUAD","INJ 0.5ML","0.5","Select","Select",""],["","58160081912","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","49281012165","FLUZONE","INJ 2021-22","0.7","Select","Select",""],["","00005197102","PREVNAR","INJ ","0.5","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0.25","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":""}]}]}