{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CNAS E AIRAMSOIRREB ZEH","gend":1,"add":"       RD  DOOWNROHT 7026                         ","city":"ALEXANDRIA               ","state":"VA","zip":"22310-9998","dob":"1947-12-26","age":"","mstatus":"","insh":"10110938","cliId":"","pno":"2630725492","cno":"","email":"","ename":"","eno":"","pphy":"HERRERA, ALBERT A","ppno":7037802800,"pcpadd":"8988 LORTON STATION BLVD STE 100,STE 306","pcpcity":"Lorton","pcpstate":"VA","pcpzip":220794757,"pcpcounty":"","pcpid":"","pcpname":"MT VERNON INTERNAL MEDICINE PRIVIA MEDICAL GROUP","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"6207 THORNWOOD  DR                                ","madd2":"                                                  ","madd3":"","mcity":"ALEXANDRIA               ","mstate":"VA","mzip":"22310-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","E11.9","E78.5","G30.9","Z23","I12.9","Z68.25","E66.3","Z91.81","Z13.31","Z13.820","E03.9","K21.00","N18.4","E11.22","Z00.00"," "],"date":["2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-14","2021-10-07","2021-10-07","2021-10-14"],"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":[["","31722088490","ROSUVASTATIN","TAB 20MG","90","Select","Select",""],["","00093727256","PIOGLITAZONE","TAB 30MG","90","Select","Select",""],["","60505006501","OMEPRAZOLE","CAP 20MG","180","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","00597014860","JENTADUETO","TAB 2.5-1000","180","Select","Select",""],["","43547027609","DONEPEZIL","TAB 10MG","90","Select","Select",""],["","69238183007","LEVOTHYROXIN","TAB 25MCG","90","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","90","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":""}]}]}