{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" DRAHCIRNACNUD M","gend":0,"add":"       RD LAYOR NELG 2198                         ","city":"CHESTERFIELD             ","state":"VA","zip":"23832-9998","dob":"1997-10-28","age":"","mstatus":"","insh":"10112346","cliId":"","pno":"0340855821","cno":4343150046,"email":"","ename":"","eno":"","pphy":"  TAMMY J WINGO","ppno":4343942422,"pcpadd":"1100 W 3RD ST,","pcpcity":"Farmville","pcpstate":"VA","pcpzip":239012628,"pcpcounty":"","pcpid":"","pcpname":"TAMMY J WINGO","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"8912 GLEN ROYAL DR                                ","madd2":"                                                  ","madd3":"","mcity":"CHESTERFIELD             ","mstate":"VA","mzip":"23832-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J06.9","R30.0","E78.5","Z71.3","Z78.9","Z71.82","Z68.28","N41.9","R35.0","H40.011","H47.22","H52.13","H52.223","Z96.1","L20.9","J30.9","Z68.34","Z00.00","R53.83","E66.09","Z23","H66.003","H61.23","H66.002","N39.0","I10","G80.9","K21.9","F70","R39.12","Z68.32","G93.89","I63.9","H53.451","R90.89","R51.9","H54.7","F43.23","F43.10"," ","B35.4","H61.20","Z76.89","H40.021"],"date":["2022-01-06","2022-10-14","2022-01-06","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-14","2022-04-07","2022-03-30","2022-12-07","2022-12-07","2022-02-10","2022-12-07","2021-06-02","2021-06-02","2021-11-02","2021-08-26","2021-08-27","2021-11-02","2020-10-15","2021-11-02","2021-11-02","2021-12-03","2021-12-03","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-03-18","2022-05-18","2022-03-30","2022-03-30","2022-03-30","2022-03-30","2022-05-18","2022-09-09","2022-09-09","2022-12-07","2022-10-25","2022-11-10","2022-11-10","2022-12-07"],"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":[["","68462039710","OMEPRAZOLE","CAP 40MG","31","Select","Select",""],["","67877019810","AMLODIPINE","TAB 5MG","31","Select","Select",""],["","43547035110","LISINOPRIL","TAB 2.5MG","31","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","62756016013","TAMSULOSIN","CAP 0.4MG","26.00","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","51672129801","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","49884072703","DOXYCYC","CAP 100MG","28.00","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","57237023305","SMZ-TMP","TAB 800-160","20","Select","Select",""],["","51224002230","AZITHROMYCIN","TAB 250MG","6.00","Select","Select",""],["","51672127501","CLOTRIMAZOLE","CRE 0.01","15","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":""}]}]}