{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ATNAYEKLLEWOP D","gend":1,"add":"        TEERTS NIAM N 603                         ","city":"FRANKLIN                 ","state":"VA","zip":"23851-9998","dob":"1986-07-07","age":"","mstatus":"","insh":"10113029","cliId":"","pno":"5675782543","cno":7576536515,"email":"","ename":"","eno":"","pphy":"BROWN-TRUDEL, LINDA","ppno":7573045570,"pcpadd":"1357 ARMORY DR,","pcpcity":"Franklin","pcpstate":"VA","pcpzip":238512419,"pcpcounty":"","pcpid":"","pcpname":"FRANKLIN COMMUNITY HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APT A                                             ","add3":"","madd1":"306 N MAIN STREET                                 ","madd2":"APT A                                             ","madd3":"","mcity":"FRANKLIN                 ","mstate":"VA","mzip":"23851-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.2","N83.201","N80.3","N83.209","R10.2","D64.9","F14.20","R09.02","R10.9","N76.0","B96.89","Z71.1","N80.9","F10.10","D57.3","Z87.440","Z87.891","Z98.84","Z90.721","Z82.49","Z83.3","Z79.899","G89.29","E66.9","Z68.39","Z20.2","R10.31","F31.9","R31.9","Z68.37","Z12.4","N83.291","Z01.411","Z01.818","Z32.02","Z01.812","N80.30","N94.5","R11.10","N93.9","D72.829"," ","N80.03","N80.201","N80.101","Z53.31","J03.90"],"date":["2022-11-16","2022-09-21","2022-06-02","2022-10-31","2022-10-31","2022-05-04","2022-03-22","2022-08-16","2022-09-21","2022-04-24","2022-04-24","2022-04-24","2022-11-05","2022-08-16","2022-08-16","2022-08-16","2022-09-21","2022-09-21","2022-08-16","2022-08-16","2022-08-16","2022-10-10","2022-08-14","2022-08-14","2022-08-14","2022-04-24","2022-05-04","2022-05-04","2022-05-04","2022-05-04","2022-08-22","2022-05-05","2022-08-22","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2022-10-31","2022-09-21","2022-09-21","2022-09-21","2022-11-16","2022-11-11","2022-11-11","2022-11-11","2022-11-11","2022-11-05"],"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":[["","59148001971","ABILIFY","INJ 400MG","1.00","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","16571066401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","70010013901","NAPROXEN","TAB 500MG","20","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","15","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","6","Select","Select",""],["","70700010616","CLOBETASOL","OIN 0.0005","60","Select","Select",""],["","00093506101","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","28","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":""}]}]}