{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ELGAOCYELVARG","gend":0,"add":"        ECALP SREWOP 7911                         ","city":"PULASKI                  ","state":"VA","zip":"24301-9998","dob":"1954-11-21","age":"","mstatus":"","insh":"10112874","cliId":"","pno":"2604515419","cno":5403152851,"email":"","ename":"","eno":"","pphy":"STEWART, KNOTRESHA F","ppno":5408350500,"pcpadd":"2832 TOWN CENTER DR,","pcpcity":"DUBLIN","pcpstate":"VA","pcpzip":240846069,"pcpcounty":"","pcpid":"","pcpname":"RIVER VALLEY HEALTHCARE ASSOCIATES PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1197 POWERS PLACE                                 ","madd2":"                                                  ","madd3":"","mcity":"PULASKI                  ","mstate":"VA","mzip":"24301-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M51.16","Z79.891","G89.4","M51.36","M54.16","M54.50","M19.90","Z51.81","M96.1","M54.5","G89.29","R63.4","G25.2","M19.049","Z11.4","Z13.220","Z12.5","F17.200","Z13.6","Z11.59","F33.2","Z23","D75.89","J44.9","F41.9","H25.13","H35.363","H25.11","M54.51","M70.61","M47.817","M47.816"," "],"date":["2022-09-01","2022-11-01","2022-11-01","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2022-11-01","2022-09-01","2021-09-28","2021-05-11","2020-11-03","2020-11-03","2020-12-01","2020-11-03","2020-11-03","2020-11-03","2020-11-03","2020-11-03","2020-11-03","2020-11-03","2020-12-01","2020-12-02","2020-12-01","2020-12-01","2022-07-08","2022-07-08","2022-07-08","2022-07-06","2022-09-01","2022-09-01","2022-09-01","2022-11-01"],"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":[["","00406052301","OXYCOD\/APAP","TAB 10-325MG","120","Select","Select",""],["","68462012605","GABAPENTIN","TAB 600MG","120","Select","Select",""],["","70461012103","FLUAD","INJ 2021-22","0.5","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","00093005301","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","00173086910","ANORO","AER 62.5-25","60","Select","Select",""],["","60505100301","KETOROLAC","SOL 0.005","5","Select","Select",""],["","61314063705","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00603548232","PROPRANOLOL","TAB 10MG","60","Select","Select",""],["","13107003105","MIRTAZAPINE","TAB 15MG","90","Select","Select",""],["","16714073201","CELECOXIB","CAP 100MG","180","Select","Select",""],["","65862019201","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","68462025501","ROPINIROLE","TAB 1MG","30","Select","Select",""],["","69315030802","CIPROFLOXACN","SOL 0.3% OP","5","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}