{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ADNERBHTIMS ","gend":1,"add":"       ELCRIC DOOWHCIR 18                         ","city":"MARTINSVILLE             ","state":"VA","zip":"24112-9998","dob":"1958-12-19","age":"","mstatus":"","insh":"10111009","cliId":"","pno":"3367270086","cno":2762295271,"email":"","ename":"","eno":"","pphy":"FATADE, AYOKUNLE O","ppno":2766321872,"pcpadd":"1100 SPRUCE ST,","pcpcity":"Martinsville","pcpstate":"VA","pcpzip":241124509,"pcpcounty":"","pcpid":"","pcpname":"FATADE HEALTH AND MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"81 RICHWOOD CIRCLE                                ","madd2":"                                                  ","madd3":"","mcity":"MARTINSVILLE             ","mstate":"VA","mzip":"24112-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H25.13","E11.9","H25.11","M54.50","M25.552","J44.9","L03.031","K59.00","F31.9","F17.298","G89.4","G89.21","F41.1","R07.9","M47.816","M47.817","M43.16","M25.78","A41.9","J18.9","J96.01","N17.9","J44.0","F17.210","H26.9","G89.29","F32.A","I10","E78.5","Z20.822","Z79.84","Z79.899","M17.0","R09.02","J18.1","M17.11","M25.461","G47.00","R41.0","R91.8","B35.1","M79.676","G44.311","E11.65","R73.03","R79.89","E07.9","E78.9","D51.9","E55.9","Z13.9"," ","E66.9","R10.819","M25.569","K22.4","R10.9","K44.9","R11.0","R60.0","R12","M25.561"],"date":["2022-03-23","2022-09-12","2022-03-23","2022-10-11","2022-11-15","2022-11-15","2022-08-24","2022-11-15","2022-11-15","2022-07-27","2022-11-15","2022-06-06","2022-09-13","2022-05-12","2022-08-02","2022-08-02","2022-08-02","2022-08-02","2022-05-11","2022-05-12","2022-05-12","2022-05-11","2022-05-11","2022-05-11","2022-05-11","2022-10-28","2022-05-11","2022-05-11","2022-05-11","2022-05-11","2022-05-11","2022-05-11","2022-07-29","2022-05-12","2022-05-11","2022-10-28","2022-07-29","2022-06-27","2022-05-11","2022-05-11","2022-05-09","2022-05-09","2022-08-30","2022-10-19","2022-10-19","2022-10-19","2022-10-19","2022-10-19","2022-10-19","2022-10-19","2022-10-19","2022-12-06","2022-10-19","2022-10-11","2022-10-11","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2022-10-19","2022-10-19","2022-12-06"],"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":[["","51991070610","ALPRAZOLAM","TAB 1MG","90.00","Select","Select",""],["","67877043103","ARIPIPRAZOLE","TAB 5MG","30.00","Select","Select",""],["","27241009810","DULOXETINE","CAP 30MG","30.00","Select","Select",""],["","31722091801","OXYCODONE","TAB 30MG","165.00","Select","Select",""],["","50228010510","METFORMIN","TAB 500MG","30.00","Select","Select",""],["","00185012901","BUMETANIDE","TAB 1MG","30.00","Select","Select",""],["","50228018005","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","68382000106","PAROXETINE","TAB 40MG","90.00","Select","Select",""],["","57237016999","ROSUVASTATIN","TAB 10MG","90.00","Select","Select",""],["","00832532510","POT  CL MICRO","TAB 20MEQ ER","30","Select","Select",""],["","55111064505","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","45802011222","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","16729031801","OXYBUTYNIN","TAB 10MG ER","30","Select","Select",""],["","58160089052","FLUARIX","INJ 2022-23","0.5","Select","Select",""],["","69097015915","MELOXICAM","TAB 15MG","30.00","Select","Select",""],["","65862050301","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10.20","Select","Select",""],["","00069024430","TOVIAZ","TAB 8MG","30.00","Select","Select",""],["","00781729685","ALBUTEROL","AER HFA","6.7","Select","Select",""],["","62135062605","DOXYCYCL","TAB 100MG","15","Select","Select",""],["","70954006030","PREDNISONE","TAB 20MG","5","Select","Select",""],["","42192071506","CICLOPIROX","SOL 0.08","6.6","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":""}]}]}