{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LATSIRHCLLIG G ","gend":1,"add":"         TS TTENNEB 09342                         ","city":"PARKSLEY                 ","state":"VA","zip":"23421-9998","dob":"1979-05-23","age":"","mstatus":"","insh":"10112008","cliId":"","pno":"6675751745","cno":"","email":"","ename":"","eno":"","pphy":"RODRIGUEZ, JOSE HIRAM","ppno":7576655996,"pcpadd":"17385 LANKFORD HWY,","pcpcity":"Parksley","pcpstate":"VA","pcpzip":234213882,"pcpcounty":"","pcpid":"","pcpname":"MEDICAL CENTER AT METOMPKINS SHORE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"PO BOX 111                                        ","madd2":"                                                  ","madd3":"","mcity":"PARKSLEY                 ","mstate":"VA","mzip":"23421-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","J45.909","J30.89","M75.102","S46.012A","G89.29","G89.4","G43.909","M54.59","M25.561","E11.40","M25.512","M79.673","M54.2","R32","S49.92XD","Z01.818","Z71.3","M54.5","Z79.899","G43.919","R51.9","Z87.891","L30.1","R63.5","R11.10","V89.9XXS","S43.402A","M75.112","X58.XXXA","M75.52","F17.210","Z88.5","Z88.8","Z91.013","Z91.030","Z98.1","T78.40XA","F41.9","G89.18","G56.03","M24.112","F43.10","R10.2","N93.9","N39.3","Z12.4"," ","R19.7","K52.9"],"date":["2022-11-13","2022-03-01","2022-01-03","2022-01-06","2022-03-08","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-12-01","2022-02-02","2022-02-02","2022-02-02","2021-09-29","2022-11-13","2021-08-28","2022-11-13","2021-08-28","2021-09-16","2021-09-22","2022-11-13","2021-12-15","2022-03-08","2022-03-08","2022-03-08","2022-03-08","2022-11-13","2022-03-08","2022-03-08","2022-03-08","2022-03-08","2022-03-08","2022-03-08","2022-03-08","2022-03-08","2022-11-17","2022-03-08","2022-08-08","2022-12-09","2022-12-09","2022-09-13","2022-09-13","2022-12-09","2022-11-13","2022-11-13"],"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":[["","55111017915","TIZANIDINE","TAB 2MG","60","Select","Select",""],["","27808003602","HYDROCO\/APAP","TAB 7.5-325","120","Select","Select",""],["","00173072020","FLOVENT","AER 220MCG","36","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","48","Select","Select",""],["","68180029606","DULOXETINE","CAP 60MG","60","Select","Select",""],["","68382080601","TRAZODONE","TAB 100MG","60","Select","Select",""],["","59148003813","REXULTI","TAB 2MG","30","Select","Select",""],["","68382014114","TOPIRAMATE","TAB 200MG","30","Select","Select",""],["","69238111801","BUSPIRONE","TAB 15MG","120","Select","Select",""],["","76204020060","ALBUTEROL","NEB 0.00083","360","Select","Select",""],["","59651036105","IBUPROFEN","TAB 600MG","90","Select","Select",""],["","56151146001","TRUE","TES GLUCOSE","100","Select","Select",""],["","45802005536","TRIAMCINOLON","OIN 0.001","80","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","15","Select","Select",""],["","69547035302","NARCAN","SPR ","2","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}