{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" EIGRAMSIVAD C","gend":1,"add":"         DR KCILKCOR 0111                         ","city":"OAKWOOD                  ","state":"VA","zip":"24631-9998","dob":"1963-06-05","age":"","mstatus":"","insh":"10111217","cliId":"","pno":"2567282459","cno":2762595428,"email":"","ename":"","eno":"","pphy":"COPLEY, CHRISTOPHER","ppno":2764983446,"pcpadd":"8243 RIVERSIDE DR,","pcpcity":"Oakwood","pcpstate":"VA","pcpzip":246318973,"pcpcounty":"","pcpid":"","pcpname":"BUCHANAN HEALTH CARE LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"PO BOX 155                                        ","madd2":"                                                  ","madd3":"","mcity":"OAKWOOD                  ","mstate":"VA","mzip":"24631-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E89.0","C73","E83.51","L85.3","L53.8","L29.8","L82.0","M19.90","M54.50","E03.9","M54.5","M51.37","R20.0","R53.81","E55.9","M54.30","M51.27","M47.817","M51.16","F17.210","Z85.850","L82.1","D22.4","D48.5","L90.5","D22.62","Z08","Z85.828","R53.83","E78.5","J20.9","R05.9","E78.00","H25.813","H02.831","H02.834","H02.413","M48.062","H25.812","M51.17","H25.811","Z96.1","J32.1","U07.1","Z20.822","F34.1","R50.9","M54.2","Z12.4","M47.812","Z01.411","Z78.0","I10","Z12.31","N95.2","R63.8"," ","K59.03","Z86.010"],"date":["2022-02-08","2022-02-08","2022-06-15","2022-01-13","2022-01-13","2022-01-13","2022-01-13","2022-11-21","2022-08-24","2022-11-21","2021-11-01","2021-04-30","2022-09-19","2022-09-22","2021-04-30","2021-05-11","2021-05-13","2021-05-13","2022-07-26","2022-11-03","2021-05-27","2021-08-19","2021-08-19","2021-09-16","2021-09-16","2021-09-30","2021-09-16","2022-11-03","2022-09-22","2022-11-03","2022-09-16","2022-11-03","2022-04-06","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-21","2022-05-26","2022-05-25","2022-06-23","2022-06-23","2022-07-11","2022-07-11","2022-09-16","2022-06-15","2022-09-16","2022-09-19","2022-11-03","2022-09-19","2022-11-03","2022-11-03","2022-11-03","2022-11-03","2022-11-03","2022-11-03","2022-12-07","2022-12-07","2022-12-07"],"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":[["","64380072406","CALCITRIOL","CAP 0.5MCG","30","Select","Select",""],["","50228013690","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30","Select","Select",""],["","00527328746","LEVOTHYROXIN","TAB 137MCG","30","Select","Select",""],["","57664037708","TRAMADOL","TAB 50MG","90.00","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","00065924007","DUREZOL","EMU 0.0005","5","Select","Select",""],["","60505058204","MOXIFLOXACIN","SOL HCL 0.5%","3","Select","Select",""],["","45802041926","AMMONIUM","LOT 0.12","400","Select","Select",""],["","00074372790","SYNTHROID","TAB 137MCG","30","Select","Select",""],["","72205002390","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","23155002401","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","20","Select","Select",""],["","51224002218","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59746017206","PREDNISONE","TAB 5MG","20","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","200","Select","Select",""],["","00185061501","HYDROXYZ","CAP 50MG","30","Select","Select",""],["","59267102501","PFIZER","INJ ADLT RTU","0.3","Select","Select",""],["","66993000210","ESTRADIOL","CRE 0.0001","42.5","Select","Select",""],["","00472082516","ALBUTEROL","SYP 2MG\/5ML","240","Select","Select",""],["","00093310953","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","49884090738","MEGESTROL","SUS 40MG\/ML","600","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}