{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"M ENAJGNIK ","gend":1,"add":"       DR SKAO LARO 94911                         ","city":"VICTORIA                 ","state":"VA","zip":"23974-9998","dob":"1955-11-15","age":"","mstatus":"","insh":"10111437","cliId":"","pno":"6340869951","cno":8043165996,"email":"","ename":"","eno":"","pphy":"GILLIAM, THEOPOLIS","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":"11949 ORAL OAKS RD                                ","madd2":"                                                  ","madd3":"","mcity":"VICTORIA                 ","mstate":"VA","mzip":"23974-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E10.40","M76.899","M79.673","R20.2","L60.1","E11.9","I10","E03.9","K21.9","E78.2","F32.9","G62.9","D64.9","E55.9","Z23","N30.01","Z68.34","R35.0","Z71.89","Z71.3","F41.9","Z12.11","I12.9","E11.22","N18.2","D63.1","Z79.899","N18.9","R39.9","K52.9","D50.9","E11.8","R10.84","Z01.812","Z20.822","R19.7","K57.30","R10.9","K64.1","K64.4","E11.40","E78.00","E78.5","Z88.1","K57.90","K64.8","Z79.4","E78.49","E87.5","E11.649","E11.65","E66.3","E88.9","E66.9","N12","N13.30","Z09","N39.0","R31.9","M79.10","Z12.39","Z12.31","E78.4","H25.11","E11.3493","H43.11","H02.59","Z96.1","Z01.30","M79.671","M79.672","R19.4","R42","R51.9","A41.9","Z11.59","E87.2","B96.20","R65.20","U07.1","R11.10","R53.1","S29.9XXA","S39.91XA","S39.93XA","E11.3393","E11.42","Z68.31","Z79.82","Z90.49","Z00.00"," "],"date":["2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-12-12","2022-12-12","2022-12-12","2022-12-12","2022-12-12","2022-12-12","2022-12-12","2022-12-12","2022-12-12","2022-11-08","2022-12-12","2022-01-18","2021-02-05","2022-11-08","2022-11-08","2021-02-05","2021-02-05","2021-09-14","2021-10-11","2021-09-14","2021-09-14","2021-03-02","2021-10-11","2022-09-07","2021-05-11","2021-05-11","2021-04-29","2021-04-29","2021-05-05","2022-08-07","2021-05-11","2021-05-11","2022-05-24","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2022-08-07","2021-05-11","2021-05-18","2021-05-11","2022-08-07","2021-09-07","2021-09-13","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2022-08-07","2021-10-31","2021-10-31","2022-08-17","2022-09-16","2021-11-04","2021-11-04","2022-02-25","2022-02-25","2021-09-07","2022-09-12","2022-09-12","2022-09-12","2022-09-12","2022-09-12","2022-11-08","2022-05-24","2022-05-24","2022-06-07","2022-08-07","2022-05-24","2022-08-11","2022-08-17","2022-08-11","2022-08-11","2022-08-11","2022-08-07","2022-08-07","2022-08-07","2022-08-07","2022-08-07","2022-08-07","2022-09-12","2022-08-07","2022-08-07","2022-08-07","2022-08-07","2022-11-08","2022-12-12"],"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":[["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","31722070090","LOSARTAN","TAB 25MG","90","Select","Select",""],["","08290320749","BD  PEN NEEDL","MIS 32GX6MM","200","Select","Select",""],["","16714008210","HYDROXYZ","TAB 25MG","90","Select","Select",""],["","00006057561","JANUMET","TAB 50-500MG","180","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","00169369619","NOVOLOG","INJ FLEXPEN","30","Select","Select",""],["","00002879759","HUMALOG","INJ 75\/25KWP","30","Select","Select",""],["","72205000390","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","16714004107","ALLOPURINOL","TAB 100MG","90","Select","Select",""],["","31722054201","INDOMETHACIN","CAP 25MG","21","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","73070010315","INSULIN","INJ FLEXPEN","60","Select","Select",""],["","72305020030","EUTHYROX","TAB 200MCG","90.00","Select","Select",""],["","00781286810","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","8","Select","Select",""],["","68645057154","CITALOPRAM","TAB 40MG","90","Select","Select",""],["","50228018005","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","67877021520","CEFUROXIME","TAB 250MG","10","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","30","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","28","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","00597014660","JENTADUETO","TAB 2.5-500","60","Select","Select",""],["","68382077306","EZETIMIBE","TAB 10MG","90","Select","Select",""],["","47781066890","LEVOTHYROXIN","TAB 200MCG","90","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","14","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","55111015430","ONDANSETRON","TAB 8MG","10","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}