{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DRAHCIRSKOORB ","gend":0,"add":"    DAOR LLIM STTAYW 3681                         ","city":"JARRATT                  ","state":"VA","zip":"23867-9998","dob":"1956-06-22","age":"","mstatus":"","insh":"10110309","cliId":"","pno":"9543439304","cno":"","email":"","ename":"","eno":"","pphy":"ANDERSON, MICHAEL S","ppno":4346346101,"pcpadd":"6 DOCTORS DR,","pcpcity":"Emporia","pcpstate":"VA","pcpzip":238471240,"pcpcounty":"","pcpid":"","pcpname":"EMPORIA MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"PO BOX 102                                        ","madd2":"                                                  ","madd3":"","mcity":"JARRATT                  ","mstate":"VA","mzip":"23867-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H25.13","H35.412","I10","E78.00","F32.9","Z71.6","F17.210","F33.40","Z00.00","Z13.39"," ","L60.1","M79.674","M79.675","L85.3","B35.1","F25.1","F33.41","Z23","Z12.5"],"date":["2022-02-11","2022-02-11","2022-11-08","2022-11-08","2022-08-04","2022-11-08","2022-11-08","2022-10-27","2022-08-04","2022-08-04","2022-11-08","2022-09-08","2022-09-08","2022-09-08","2022-09-08","2022-09-08","2022-10-27","2022-11-08","2022-11-08","2022-08-04"],"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":[["","76385011050","CARVEDILOL","TAB 3.125MG","60.00","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30.00","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","30.00","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30.00","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","30.00","Select","Select",""],["","68180051303","LISINOPRIL","TAB 5MG","30.00","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":""}]}]}