{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"N YELHSADROFDER ","gend":1,"add":"        DR NERGLHAD 24101                         ","city":"KING GEORGE              ","state":"VA","zip":"22485-9998","dob":"1990-12-02","age":"","mstatus":"","insh":"10111754","cliId":"","pno":"1404207949","cno":"","email":"","ename":"","eno":"","pphy":"DEDWYLDER, ROSIER D","ppno":5406449505,"pcpadd":"16463 DAHLGREN RD,","pcpcity":"King George","pcpstate":"VA","pcpzip":224855810,"pcpcounty":"","pcpid":"","pcpname":"SENTARA PRATT MEDICAL GROUP","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"10142 DAHLGREN RD                                 ","madd2":"                                                  ","madd3":"","mcity":"KING GEORGE              ","mstate":"VA","mzip":"22485-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N39.0","Z34.90","Z33.1","Z34.01","Z3A.11","Z3A.12","Z34.02","O20.0","O26.851","O23.41","O20.9","Z3A.01","O02.1","Z32.01","Z01.818","Z20.822","Z82.49","N93.8","N93.9","Z87.59","Z98.890","Z79.3","N83.209","R10.2","Z20.828","Z00.00","Z68.26","N92.6","Z36.87","Z01.419","Z12.4","Z30.40","N83.202","Z11.3","S16.1XXA"," "],"date":["2021-02-15","2021-02-03","2021-02-03","2021-02-12","2021-02-03","2021-02-15","2021-02-12","2021-02-14","2021-02-14","2021-02-14","2021-02-15","2021-02-14","2021-02-18","2021-02-15","2021-02-17","2021-02-17","2021-02-18","2021-04-09","2021-05-06","2021-04-09","2021-04-09","2021-04-09","2021-05-26","2022-02-25","2021-08-27","2020-09-25","2020-09-25","2021-11-18","2020-12-31","2022-02-25","2022-02-25","2022-02-25","2022-03-08","2022-08-24","2022-09-19","2022-09-19"],"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":[["","00006412102","GARDASIL","INJ ","0.5","Select","Select",""],["","00555902658","JUNEL","TAB 44581","84","Select","Select",""],["","68462030450","NORETHIN","TAB 5MG","10","Select","Select",""],["","59267030401","PFIZER","INJ BA4\/BA5","0.3","Select","Select",""],["","70461032203","FLUCLVX","INJ 2022-23","0.5","Select","Select",""],["","49281042050","FLUZONE","INJ 2020-21","0.5","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","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":["",""]}},{"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":""}]}]}