{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" EITTAMTTAYW K","gend":1,"add":"RAM 732ENAL HS","city":"KING WILLIAM","state":"VA","zip":"23086-9998","dob":"1939-01-17","age":"","mstatus":"","insh":"10110007","cliId":"","pno":"4840893030","cno":"","email":"","ename":"","eno":"","pphy":"PAUL, CHRISTINE E","ppno":"8047691245          ","pcpadd":"4730 N Southside Plaza St, ","pcpcity":"4730 N Southside Plaza St,","pcpstate":"VA","pcpzip":"232241742","pcpcounty":"","pcpid":"","pcpname":"KING WILLIAM MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"PO BOX 14","madd2":"","madd3":"","mcity":"KING WILLIAM","mstate":"VA","mzip":"23086-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z12.31","I12.9","F32.0","E78.2","I50.33","N18.4","M89.49","K58.2","J30.89","I50.32","G56.01","N17.9","I49.9","D64.9","I10","R30.0","N30.00","Z68.22","R63.4","R42","R51.9","T50.905A","F32.9","Z88.8","Z79.899","T43.595A","R10.84","Z23","Z00.00","K57.90","M85.89","F41.9","Z20.822","L30.9","N76.0","Z68.23","R79.9","M17.0","R09.02","M17.11","M17.12","J98.4","W19.XXXA","I95.9","M25.561","M25.562","J81.1","J96.01","I11.0","R77.8","R65.10","R06.02","A41.9","K21.9","R91.8","J80","J96.91","E11.9","J18.1","D72.825","J84.9","J18.9","N18.31","R74.01","Z68.24","Z46.82","Z51.5","R63.0","R53.1","R73.9","F32.A"],"date":["2022-03-05","2022-03-16","2022-03-31","2022-01-27","2022-04-04","2022-03-23","2022-01-27","2021-10-26","2021-10-26","2022-03-16","2022-01-27","2022-04-04","2021-01-29","2022-04-04","2022-03-25","2021-07-26","2021-08-31","2021-08-31","2021-08-31","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2021-11-11","2021-11-19","2021-11-19","2022-03-11","2021-11-02","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2022-03-11","2022-03-16","2022-04-04","2022-03-15","2022-03-24","2022-04-04","2022-03-29","2022-03-16","2022-03-16","2022-03-24","2022-03-20","2022-03-25","2022-03-25","2022-03-21","2022-04-04","2022-04-04","2022-04-04","2022-04-04","2022-04-04","2022-03-24","2022-03-25","2022-03-29","2022-03-29","2022-03-29","2022-04-04","2022-04-04"],"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":[["","68645051554","AMLODIPINE","TAB 5MG","90.00","Select","Select",""],["","13668021730","ARIPIPRAZOLE","TAB 5MG","30.00","Select","Select",""],["","31722052201","HYDRALAZINE","TAB 100MG","90.00","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","90.00","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8.50","Select","Select",""],["","68382000106","PAROXETINE","TAB 40MG","30.00","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","90.00","Select","Select",""],["","68645052354","SERTRALINE","TAB 100MG","180.00","Select","Select",""],["","33342006410","VALSARTAN","TAB 160MG","30.00","Select","Select",""],["","29300013701","CLONIDINE","TAB 0.3MG","60.00","Select","Select",""],["","00713063415","MOMETASONE","CRE 0.001","15.00","Select","Select",""],["","00093505998","ATORVASTATIN","TAB 20MG","90.00","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1.00","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","120.00","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":""}]}]}