{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ECNERWALNYWDOOG D","gend":0,"add":"   YAWHGIH DROFKNAL 55091                         ","city":"CAPE CHARLES             ","state":"VA","zip":"23310-9998","dob":"1954-04-02","age":"","mstatus":"","insh":"10111602","cliId":"","pno":"1775789460","cno":"","email":"","ename":"","eno":"","pphy":"BICE, HAMILTON L","ppno":7573311422,"pcpadd":"216 MASON AVE,  ","pcpcity":"Cape Charles","pcpstate":"VA","pcpzip":233103200,"pcpcounty":"","pcpid":"","pcpname":"CAPE CHARLES MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"19055 LANKFORD HIGHWAY                            ","madd2":"                                                  ","madd3":"","mcity":"CAPE CHARLES             ","mstate":"VA","mzip":"23310-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H40.043","H20.043","J06.9","U07.1","E11.9","E78.00","Z12.5","I10","Z87.891","Z79.84","I70.209","Z86.73","Z23","K57.91","K92.2","R55","Z91.81","N20.0","I71.4","I25.10","K21.9","Z79.82","Z79.899","I49.1","I45.10","R94.31","Z09","D50.0","Z87.19","K57.31","K62.5","Z12.11","M10.071","H25.813","Z01.818","H25.9","D12.3","D12.5","K64.8","K57.30","K63.5","K62.1","E78.5","M10.079","Z01.810","H25.811","H25.812","E11.22","N18.1","E11.51","I12.9","Z00.00","Z79.4"],"date":["2022-06-17","2022-06-17","2022-01-14","2022-01-14","2022-06-24","2022-06-24","2022-06-24","2022-06-24","2022-06-24","2021-09-02","2021-01-26","2021-09-02","2022-06-01","2021-05-04","2021-05-04","2021-05-05","2021-05-04","2021-05-04","2021-05-04","2021-10-07","2021-09-02","2021-09-02","2021-09-02","2021-05-05","2021-05-05","2021-05-05","2021-05-10","2022-06-24","2021-05-10","2021-09-02","2021-09-02","2021-05-24","2020-06-23","2021-08-24","2021-09-01","2021-09-01","2021-09-03","2021-09-03","2021-09-02","2021-09-02","2021-09-02","2021-09-03","2021-10-07","2021-09-02","2021-09-02","2021-09-13","2021-09-27","2021-10-07","2020-09-23","2021-10-07","2021-10-07","2022-03-24","2022-06-24"],"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":[["","42571014726","DORZOL\/TIMOL","SOL 22.3-6.8","10","Select","Select",""],["","43547035411","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","00781600078","DIFLUPREDNAT","EMU 0.0005","10","Select","Select",""],["","60758011905","PREDNISOLONE","SUS 1% OP","10","Select","Select",""],["","67877058901","COLCHICINE","TAB 0.6MG","60","Select","Select",""],["","00193737701","CONTOUR","KIT NEXT","1","Select","Select",""],["","52268020101","SUTAB","TAB ","24","Select","Select",""],["","70461012103","FLUAD","INJ 2021-22","0.50","Select","Select",""],["","61314014305","BRIMONIDINE","SOL 0.2% OP","5.00","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":""}]}]}