{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" AUHSOJDEER L","gend":0,"add":"     ENAL MRAF ELEETS 111                         ","city":"PATRICK SPRINGS          ","state":"VA","zip":"24133-9998","dob":"1984-02-12","age":"","mstatus":"","insh":"10113086","cliId":"","pno":"9667222262","cno":2762296909,"email":"","ename":"","eno":"","pphy":"COLE, RICHARD C","ppno":2766944466,"pcpadd":"18877 JEB STUART HWY,","pcpcity":"Stuart","pcpstate":"VA","pcpzip":241715223,"pcpcounty":"","pcpid":"","pcpname":"PATRICK COUNTY FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"111 STEELE FARM LANE                              ","madd2":"                                                  ","madd3":"","mcity":"PATRICK SPRINGS          ","mstate":"VA","mzip":"24133-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F43.10","F31.81","H53.003","R50.9","Z20.828","R05","R06.02","K29.01","E66.01","I10","K92.0","K21.9","R11.10","R51.9","R11.2","K12.2","K52.9","R10.13","R68.81","F17.218","F41.1","Z11.52","Z00.00","B34.9","E66.8","R20.9","R73.9","J06.9","Z20.822","I67.1","F39","R07.89","F15.10","F17.210","R05.9","R07.9","F31.9","Z79.899","T50.904A","G93.40","R56.9","Z99.11","T50.912A","G92.9","T43.222A","F32.9","G93.41","J96.01","E66.9","T14.91XA","Z79.891","Z68.34","Z88.8","Z46.82","F33.2","T50.991A","G40.89","J01.80","R41.82","R06.89"," "],"date":["2022-11-28","2022-11-28","2021-01-06","2021-01-05","2021-01-12","2021-01-12","2021-09-21","2021-01-25","2021-01-25","2021-01-25","2022-09-02","2021-02-05","2022-09-02","2021-08-16","2022-08-30","2021-06-21","2021-04-29","2021-05-03","2021-05-03","2021-05-03","2021-06-25","2022-08-30","2022-10-03","2021-05-03","2022-09-27","2022-08-30","2022-08-30","2022-08-30","2022-07-14","2022-07-14","2022-07-14","2022-10-16","2022-09-02","2022-09-02","2022-10-12","2022-09-27","2022-09-02","2022-09-02","2022-10-12","2022-10-13","2022-10-13","2022-10-13","2022-10-13","2022-10-16","2022-10-16","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-14","2022-10-18","2022-10-12","2022-10-12","2022-10-03","2022-10-13","2022-10-12","2022-11-28"],"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":[["","68180051901","LISINOP\/HCTZ","TAB 20-12.5","90","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","13668001005","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","00093221001","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","180","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","20","Select","Select",""],["","65862059401","DIVALPROEX","TAB 250MG ER","15","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0.50","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","00069047103","CHANTIX","PAK 0.5& 1MG","53","Select","Select",""],["","66689000816","NYSTATIN","SUS 100000","150","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":""}]}]}