{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"M SEMAJSNEWO ","gend":0,"add":"R STHGIEH NOTGNILRAD 2115                        D","city":"CULLEN                   ","state":"VA","zip":"23934-9998","dob":"1966-04-08","age":"","mstatus":"","insh":"10111537","cliId":"","pno":"9343414684","cno":"","email":"","ename":"","eno":"","pphy":"ALGEIER, RHONDA M","ppno":4345425522,"pcpadd":"560 GEORGE WASHINGTON HWY,","pcpcity":"Charlotte Court House","pcpstate":"VA","pcpzip":239233775,"pcpcounty":"","pcpid":"","pcpname":"RHONDA BARKSDALE ALGEIER MD AND ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"5112 DARLINGTON HEIGHTS RD                        ","madd2":"                                                  ","madd3":"","mcity":"CULLEN                   ","mstate":"VA","mzip":"23934-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E66.9","R56.9","G47.62","Z83.3","Z72.0","E55.9","E78.2","Z13.1","Z13.29","Z12.5","G47.33","Z80.42","H53.10","H53.9","Z01.89","Z76.89","Z71.89","Z71.6","Z71.3","Z86.69","I62.00","Q04.0","R06.83","G40.909","Z00.00","G40.109"," "],"date":["2021-02-09","2022-10-13","2021-04-23","2021-02-09","2021-02-09","2022-04-28","2022-04-28","2022-04-28","2022-04-28","2022-04-28","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-04-23","2022-04-28","2022-04-28","2022-04-28","2022-04-28","2021-08-19","2021-08-19","2021-07-13","2021-08-19","2021-10-29","2021-07-08","2022-10-13"],"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":[["","68180011507","LEVETIRACETA","TAB 1000MG","90","Select","Select",""],["","69097086107","ZONISAMIDE","CAP 100MG","270","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":""}]}]}