{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"H YRREPSIVAD ","gend":0,"add":"         EVA TSRUHKAO 427                         ","city":"PULASKI                  ","state":"VA","zip":"24301-9998","dob":"1983-05-13","age":"","mstatus":"","insh":"00119920","cliId":"","pno":"4604520411","cno":"","email":"","ename":"","eno":"","pphy":"STEWART, KNOTRESHA F","ppno":5408350500,"pcpadd":"2832 TOWN CENTER DR,","pcpcity":"DUBLIN","pcpstate":"VA","pcpzip":240846069,"pcpcounty":"","pcpid":"","pcpname":"RIVER VALLEY HEALTHCARE ASSOCIATES PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"724 OAKHURST AVE                                  ","madd2":"                                                  ","madd3":"","mcity":"PULASKI                  ","mstate":"VA","mzip":"24301-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F20.0","F25.1","R06.02","E55.9","Z71.6","J30.2","F12.90","R35.0","Z79.899","Z72.0","R05","R51.9","F33.2","K08.409","L81.8","Z76.89","H90.5","E78.49","R53.82","E88.81","Z51.81","Z13.1","E04.9","F31.9","F20.9","F32.9","H04.123","Q14.1","E78.5","R06.2","R05.9","R11.10","Z68.28","Z23","Z68.26"," "],"date":["2022-01-24","2022-11-30","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-10-13","2022-07-13","2021-04-27","2022-07-13","2021-12-06","2020-10-06","2020-10-06","2020-10-06","2019-05-07","2022-01-07","2022-01-07","2022-01-07","2022-01-07","2022-01-07","2018-10-01","2018-10-01","2021-03-04","2021-03-04","2022-03-01","2022-03-01","2022-10-14","2022-10-14","2022-07-13","2022-07-14","2022-07-14","2022-10-14","2022-10-14","2022-11-30"],"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":[["","12496009001","PERSERIS","INJ 90MG","1.00","Select","Select",""],["","70461042010","FLUCLVX","INJ 2020-21","0.5","Select","Select",""],["","00185041505","BUPROPION","TAB 150MG SR","56","Select","Select",""],["","60505008302","PAROXETINE","TAB 20MG","28","Select","Select",""],["","14539067505","HYDROXYZ","CAP 50MG","56","Select","Select",""],["","69315013601","BENZTROPINE","TAB 0.5MG","56","Select","Select",""],["","50458030711","RISPERDAL","INJ 37.5MG","2","Select","Select",""],["","70436001102","BUPROPN","TAB 300MG XL","28","Select","Select",""],["","00603497528","OXYBUTYNIN","TAB 5MG","90","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","20.1","Select","Select",""],["","19515081852","FLULAVAL","INJ 2021-22","0.5","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":""}]}]}