{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" N HPESOJSMAILLIW","gend":0,"add":"          tS sserpyC 5011                         ","city":"Richmond                 ","state":"VA","zip":"23222-4641","dob":"1951-12-19","age":"","mstatus":"","insh":"00118952","cliId":"","pno":"1640868970","cno":8048036031,"email":"","ename":"","eno":"","pphy":"CHARLTON, LEI S","ppno":8044691277,"pcpadd":"1122 N 25TH ST EAST END MEDICAL BUILDING STE A,STE A","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232235254,"pcpcounty":"","pcpid":"","pcpname":"LEI S CHARLTON MD PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1105 Cypress St                                   ","madd2":"                                                  ","madd3":"","mcity":"Richmond                 ","mstate":"VA","mzip":"23222-4641","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","M51.9","M25.562","J42","K21.9","E11.9","M54.5","M54.2","M48.062","M48.061","M43.16","M47.816","F17.210","F33.41","M51.36","R79.9","Z09","Z79.899","E78.2","E55.9","E66.9","E78.5","F32.9","K08.409","L72.0","R29.898","Z68.30","Z79.1","Z82.49","Z98.890","K02.9","K08.89","M51.26","E78.00","F17.200","J20.9","R05","M54.9","R06.02","H93.299","I11.9","N40.1","D17.9","R31.9"," "],"date":["2022-09-30","2018-09-10","2018-01-15","2018-01-15","2018-07-14","2018-02-15","2018-07-14","2018-02-26","2018-03-12","2018-03-08","2018-03-12","2018-03-08","2018-07-14","2021-03-08","2018-03-12","2018-09-10","2018-09-10","2018-09-10","2018-09-10","2018-03-15","2018-07-14","2018-07-14","2018-07-14","2018-07-14","2018-07-14","2018-07-14","2018-07-14","2018-07-14","2018-07-14","2018-07-14","2018-07-17","2018-07-17","2018-07-17","2018-07-21","2018-09-10","2018-07-21","2018-07-21","2018-07-21","2018-09-10","2018-09-10","2018-09-10","2022-09-30","2022-09-30","2022-09-30","2022-09-30"],"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":[["","62332015130","OLM","TAB 40-25MG","90","Select","Select",""],["","13668001101","CITALOPRAM","TAB 40MG","90","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","14","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":""}]}]}