{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" W NIVEKMUTTIHC","gend":0,"add":"              NL SAMRE 56                         ","city":"ROCKBRIDGE BATHS         ","state":"VA","zip":"24473-9998","dob":"1980-02-15","age":"","mstatus":"","insh":"00119429","cliId":"","pno":"4304540568","cno":"","email":"","ename":"","eno":"","pphy":"CALDWELL, BEVERLY G","ppno":5404633381,"pcpadd":"55 COMFORT WAY STE 1,","pcpcity":"Lexington","pcpstate":"VA","pcpzip":244503788,"pcpcounty":"","pcpid":"","pcpname":"AUGUSTA MEDICAL GROUP","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"65 ERMAS LN                                       ","madd2":"                                                  ","madd3":"","mcity":"ROCKBRIDGE BATHS         ","mstate":"VA","mzip":"24473-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.9","F32.9","K21.9","R07.9","F41.0","F10.20","S09.90XS","M25.561","F17.200","J30.9","M54.50","J01.90","G25.81"," "],"date":["2020-02-12","2022-03-02","2022-02-16","2020-01-13","2022-02-16","2020-02-10","2020-01-27","2020-01-27","2022-02-16","2022-03-02","2022-03-02","2022-04-05","2022-03-02","2022-04-05"],"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":[["","00093100305","BUSPIRONE","TAB 15MG","90","Select","Select",""],["","69097082312","CITALOPRAM","TAB 20MG","30.00","Select","Select",""],["","16729011917","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","57237016199","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","29300012410","MELOXICAM","TAB 7.5MG","30.00","Select","Select",""],["","65862052899","VENLAFAXINE","CAP 75MG ER","30","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","20","Select","Select",""],["","65162089803","ARIPIPRAZOLE","TAB 10MG","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":""}]}]}