{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"INAHPETSKCAJ E E","gend":1,"add":"B E 326YAWDAOR","city":"HOPEWELL                 ","state":"VA","zip":"23860-9998","dob":"1990-02-17","age":"","mstatus":"","insh":"00119310","cliId":"","pno":"5240865185","cno":8047222326,"email":"","ename":"","eno":"","pphy":"PASCO, HAYDEN","ppno":8047390910,"pcpadd":"13861 HULL STREET,","pcpcity":"MIDLOTHIAN","pcpstate":"VA","pcpzip":231122091,"pcpcounty":"","pcpid":"","pcpname":"PRIMARY HEALTH GROUP INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"N","ano":"","add2":"                                                  ","add3":"","madd1":"623 E BROADWAY","madd2":"                                                  ","madd3":"","mcity":"HOPEWELL                 ","mstate":"VA","mzip":"23860-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O99.212","E66.9","Z3A.18","O99.213","Z3A.28","Z68.38","Z13.1","B34.9","R53.83","R53.81","R50.9","F17.200","M54.9","R53.1","N91.1","Z32.02","N91.2","O99.810","R30.0","Z3A.22","O24.410","Z3A.31","O24.415","Z3A.35","O99.283","Z34.82","Z01.419","E28.2","N97.0","Z12.4","Z11.3","Z3A.36","O24.419","Z36.85","O36.8130","Z3A.37","O99.210","Z98.891","Z3A.38","O24.425","O34.211","O99.214","Z30.2","Z37.0","O82","Z30.09","O99.513","J20.9","Z3A.32","O69.81X0","Z3A.39","Z11.51","N39.0","O86.4","O86.20","N28.1","R10.9","S16.1XXA","M25.512","V89.2XXA","Y92.410","Z39.2","Z32.01","N96","O23.41","Z3A.01","L72.3","O36.80X0","O99.211","Z3A.09","Z34.81","Z36.89","O09.299","F43.23","F60.7","N92.6","Z36.87","Z36.3","Z3A.19","Z3A.23","Z38.01","Z23","Z05.42","Z83.3","O26.899","R10.2","Z3A.00","O26.891"],"date":["2021-06-03","2021-09-17","2019-06-26","2021-09-14","2021-07-09","2021-09-14","2021-07-09","2018-07-10","2018-07-10","2018-07-10","2019-12-07","2021-12-17","2021-12-17","2018-07-10","2018-07-16","2022-04-14","2021-01-18","2021-07-16","2021-07-16","2019-07-23","2021-09-09","2021-07-26","2021-09-14","2021-08-24","2021-08-31","2019-08-27","2021-11-29","2019-03-20","2018-09-11","2018-08-31","2021-03-08","2021-08-31","2021-09-09","2021-08-31","2021-09-07","2021-09-09","2021-09-09","2021-09-09","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2022-04-14","2019-10-02","2019-10-02","2019-10-02","2019-11-17","2019-11-17","2021-11-29","2021-01-20","2019-12-07","2019-12-07","2019-12-07","2019-12-07","2021-12-17","2021-12-17","2021-12-17","2021-12-17","2019-12-30","2022-08-01","2021-01-18","2021-01-20","2022-07-28","2020-02-13","2021-02-17","2021-02-17","2021-02-17","2021-03-08","2021-05-05","2019-03-20","2018-04-17","2018-04-17","2022-04-14","2019-04-10","2021-05-05","2021-05-05","2021-06-03","2021-09-17","2021-09-17","2021-09-17","2021-09-17","2022-07-28","2022-07-28","2022-07-28","2022-07-28"],"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":[["","69238110005","DOXYCYCL","CAP 100MG","30","Select","Select",""],["","67877056310","METFORMIN","TAB 1000MG","75","Select","Select",""],["","55111068405","IBU","TAB 800MG","60","Select","Select",""],["","27808003503","HYDROCO\/APAP","TAB 5-325MG","14","Select","Select",""],["","29300041301","CYCLOBENZAPR","TAB 5MG","20","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","15","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","21","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA","100","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","42571016242","AMOX\/K","TAB 875-125","20","Select","Select",""],["","17478076710","PROGESTERONE","CAP 200MG","30","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":""}]}]}