{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CM ELBAMNOSREHP","gend":1,"add":"        EVIRD TREBMIG 842                         ","city":"VIRGINIA BEACH           ","state":"VA","zip":"23452-9998","dob":"1934-07-09","age":"","mstatus":"","insh":"10112494","cliId":"","pno":"4375717320","cno":"","email":"","ename":"","eno":"","pphy":"JOYCE, JOHN O","ppno":7573951300,"pcpadd":"2859 VIRGINIA BEACH BLVD,  STE 200","pcpcity":"Virginia Beach","pcpstate":"VA","pcpzip":234527613,"pcpcounty":"","pcpid":"","pcpname":"SENTARA FAMILY MEDICINE PHYSICIANS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"248 GIMBERT DRIVE                                 ","madd2":"                                                  ","madd3":"","mcity":"VIRGINIA BEACH           ","mstate":"VA","mzip":"23452-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z12.31","T86.8411","H18.231","H17.11","Z94.7","H40.013","J22","R05.9","I10","E78.5","R63.4","M17.0","Z12.12","F06.8","E55.9","I73.9","Z20.828","R91.8","S09.90XA","I71.4","H04.123","H04.121","H04.122","R10.13","M79.642","R41.0","M54.2","W19.XXXA","H91.90","E78.00","Z90.710","Z82.49","Z80.3","Z80.52","Z87.891","Z68.1","Z79.82","Z79.899","I70.8","R10.9","Z00.00","M19.012","M18.12"],"date":["2021-12-30","2021-07-23","2021-07-23","2021-07-23","2022-05-26","2022-05-26","2022-01-13","2022-01-13","2022-07-14","2022-05-03","2022-07-14","2022-02-07","2022-02-07","2022-05-03","2022-02-07","2022-07-14","2021-02-19","2022-01-13","2021-11-10","2021-07-01","2022-05-26","2022-05-26","2022-05-26","2022-07-14","2021-11-10","2021-11-10","2021-11-10","2021-11-10","2021-11-10","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2021-11-10","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2021-07-01","2022-02-07","2022-02-07","2021-11-10","2021-11-10"],"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":[["","72205000490","ROSUVASTATIN","TAB 20MG","90","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","29300013701","CLONIDINE","TAB 0.3MG","135","Select","Select",""],["","49281012065","FLUZONE","INJ PF 20-21","0.7","Select","Select",""],["","00023916360","RESTASIS","EMU 0.0005","180","Select","Select",""],["","00456142090","BYSTOLIC","TAB 20MG","90","Select","Select",""],["","60758011905","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","12","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":""}]}]}