{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ACINOHSSTTUB R","gend":1,"add":" NEERG 8435DAOR NIALP","city":"NORFOLK","state":"VA","zip":"23502-9998","dob":"1975-06-06","age":"","mstatus":"","insh":"00118668","cliId":"","pno":"7375722402","cno":"","email":"","ename":"","eno":"","pphy":"CASTALDO, DAVID J","ppno":"7579552828          ","pcpadd":"885 Kempsville Rd, Ste 320","pcpcity":"Norfolk","pcpstate":"VA","pcpzip":"235023800","pcpcounty":"","pcpid":"","pcpname":"AMELIA MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"6220 Wellington St # B","madd2":"","madd3":"","mcity":"Norfolk","mstate":"VA","mzip":"23513-2020","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z20.822","M20.11","M20.12","M79.671","M79.672","R60.0","M20.40","Z01.818","M21.611","E66.01","Z68.42","Z79.82","Z98.1","R60.9","G89.18","Z48.01","Z47.89","Z91.81","L03.115","L03.116","Z12.31","M76.71","Z98.890"],"date":["2022-01-11","2021-06-25","2021-06-25","2021-06-25","2021-03-09","2021-06-25","2021-01-27","2021-01-27","2021-01-22","2021-02-10","2021-02-10","2021-02-10","2021-02-10","2021-02-10","2021-02-10","2021-02-13","2021-02-13","2021-02-13","2021-02-16","2021-02-16","2021-04-09","2021-06-25","2021-05-11"],"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":[["","58160088752","FLUARIX","INJ 2021-22","0.50","Select","Select",""],["","49281042050","FLUZONE","INJ 2020-21","0.50","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","20.00","Select","Select",""],["","10702000310","PROMETHAZINE","TAB 25MG","30.00","Select","Select",""],["","69543038810","KETOROLAC","TAB 10MG","20.00","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":""}]}]}