{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ARDNASWAL J ","gend":1,"add":"         EVIRD LERUAL 035                         ","city":"MARTINSVILLE             ","state":"VA","zip":"24112-9998","dob":"1955-12-11","age":"","mstatus":"","insh":"10111354","cliId":"","pno":"2267218644","cno":"","email":"","ename":"","eno":"","pphy":"SAAD, MOHAMMED","ppno":2766667827,"pcpadd":"320 HOSPITAL DR,","pcpcity":"Martinsville","pcpstate":"VA","pcpzip":241121900,"pcpcounty":"","pcpid":"","pcpname":"MARTINSVILLE PHYSICIAN PRACTICES LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"530 LAUREL DRIVE                                  ","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":["E11.9","E11.65","I10","E78.5","Z79.4","B35.1","Z89.512","E11.42","I73.9","N39.41","N32.81","Z99.3","I63.9","R26.2","R60.0","Z12.11","R79.89","R94.31","Z12.39","R09.89","I31.3","J90","L51.1","I69.351","R22.43","G45.9","R60.1","I50.9","D64.9","E88.09","D47.2","E61.1","I13.0","E11.22","N18.9","I69.354","Z79.02","Z79.899","Z88.0","Z88.2","Z98.890","D50.9","D89.0","E85.81","I50.89","G45.8","I63.89","I06.8","I31.4","I05.8","I51.89","J98.11","L89.90","H35.012","E11.3411","E11.3412","R60.9","I12.9","Z20.822","I08.2","Z12.31","Z86.79","R10.30","R31.9","L03.119","S90.821A","I50.32","E11.51","E78.00","I11.0","Z86.14","Z79.82","Z82.49","M54.5","R07.81","R10.32","E11.3511","E11.69","H40.1134","R63.0","R63.4","R91.8","L89.159","D64.89","Z98.49","Z86.73","I63.311","M79.674","I25.10","I25.2","M79.89","E55.9","I96","Z68.27","E11.52","I70.221","I70.261","E11.621","L97.519","E11.36","H26.9","E11.39","H42","I70.262","Z01.810","I44.4","Z48.812","E03.8","Z88.8","E04.9","E04.2","Z23","R11.0","Z88.1"," "],"date":["2022-08-11","2022-09-19","2022-11-01","2022-09-19","2022-10-21","2022-10-21","2022-10-21","2022-10-21","2022-10-21","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-10-21","2022-08-02","2022-09-13","2022-06-20","2022-04-08","2021-11-29","2022-05-09","2022-08-02","2021-02-19","2021-02-12","2022-08-23","2021-02-23","2022-09-13","2021-02-23","2022-10-10","2022-12-06","2021-02-23","2022-07-26","2022-08-23","2022-10-10","2022-10-10","2022-10-10","2021-08-04","2022-08-23","2022-10-10","2022-10-10","2022-08-23","2021-08-04","2022-10-10","2022-10-10","2021-10-06","2021-12-15","2020-12-15","2020-12-15","2021-02-09","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2021-04-02","2020-09-08","2021-06-05","2021-06-05","2020-10-27","2020-10-27","2021-02-11","2021-02-12","2022-02-21","2021-04-21","2021-07-29","2021-07-29","2022-02-08","2022-02-08","2021-06-05","2021-02-11","2021-02-11","2022-04-08","2022-04-08","2021-02-11","2022-10-10","2021-07-29","2021-07-29","2021-07-29","2020-11-19","2022-08-02","2021-06-05","2021-02-08","2021-02-08","2021-02-08","2021-06-05","2021-02-09","2021-02-09","2021-02-09","2021-12-28","2022-10-21","2022-07-26","2022-07-26","2022-03-02","2022-09-19","2022-05-09","2022-05-09","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-05-09","2022-09-19","2022-07-26","2022-08-30","2022-08-30","2022-09-13","2022-08-23","2022-10-10","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":[["","00169643810","LEVEMIR","INJ FLEXTOUC","15","Select","Select",""],["","65862052305","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","00093720198","PRAVASTATIN","TAB 20MG","90","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","1.50","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","65162074510","PROMETHAZINE","TAB 12.5MG","12","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","45","Select","Select",""],["","00023921105","COMBIGAN","SOL 0.2\/0.5%","5","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","70436015301","POT  CHLORIDE","TAB 20MEQ ER","90","Select","Select",""],["","57599080000","FREESTY","KIT 2 SENSOR","6","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","20.00","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","6","Select","Select",""],["","73070010315","INSULIN","INJ FLEXPEN","15.00","Select","Select",""],["","00832054211","BUMETANIDE","TAB 2MG","30","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","53746051401","SPIRONOLACT","TAB 50MG","90","Select","Select",""],["","76385011150","CARVEDILOL","TAB 6.25MG","180","Select","Select",""],["","68382076010","METFORMIN","TAB 1000MG","180","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","20.00","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":""}]}]}