{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AS ATRAMOLEGNATN","gend":1,"add":" ELIM RUOF S 0054821 TPA EVIRD NUR","city":"ARLINGTON                ","state":"VA","zip":"22204-9998","dob":"1945-01-09","age":"","mstatus":"","insh":"10111503","cliId":"","pno":"7430771890","cno":"","email":"","ename":"","eno":"","pphy":"MOLAIY, JOHN H","ppno":7034650137,"pcpadd":"1635 N GEORGE MASON DR STE 455,STE 300","pcpcity":"Arlington","pcpstate":"VA","pcpzip":222053678,"pcpcounty":"","pcpid":"","pcpname":"JOHN H MOLAIY","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"4500 S FOUR MILE RUN DRIVE APT 128","madd2":"                                                  ","madd3":"","mcity":"ARLINGTON                ","mstate":"VA","mzip":"22204-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z20.828","E78.5","I10","M15.0","F03.90","M81.0","M94.0","M75.32","M54.2","Z23","F11.20","Z51.81","Z79.891","D64.9","E03.9","M10.9","N39.0","R73.9","Z00.01","D61.9","E55.9","J01.00","J20.9","D51.9","R51.9","G44.86","Z12.31","M85.89","Z13.820","R92.1","N64.89","Z78.0","G44.209","R11.10"],"date":["2021-01-09","2022-08-11","2022-08-11","2022-08-11","2022-08-11","2022-08-11","2021-03-03","2021-04-19","2021-09-07","2022-04-27","2020-09-30","2020-09-30","2020-09-30","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2020-11-13","2022-06-01","2022-03-07","2022-03-17","2022-03-17","2022-04-16","2022-04-27","2022-05-06","2022-05-06","2022-05-06","2022-05-06","2022-05-06","2022-05-06","2022-04-16","2022-04-16"],"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":[["","00456120130","LINZESS","CAP 145MCG","90","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","90","Select","Select",""],["","64764024060","AMITIZA","CAP 24MCG","180","Select","Select",""],["","00456122830","NAMZARIC","CAP 28-10MG","30","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","68180021509","LOSARTAN\/HCT","TAB 50-12.5","90","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","51672401801","ETODOLAC","TAB 400MG","28","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","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":""}]}]}