{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"H M MAILLIWRJ TTUCYENU","gend":0,"add":"UT LARUTAN 56851 TOL YWKP LENN","city":"DUFFIELD","state":"VA","zip":24244,"dob":"1956-08-27","age":"","mstatus":"","insh":"10113158","cliId":"","pno":"7267252835","cno":"","email":"","ename":"","eno":"","pphy":"PARKER, DAVID G","ppno":2762753825,"pcpadd":"520 DEER RUN LN","pcpcity":"TAZEWELL","pcpstate":"VA","pcpzip":24651,"pcpcounty":"","pcpid":"","pcpname":"ADVANCED PRACTICE HEALTH CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"N","ano":"","add2":"","add3":"","madd1":"5865 NATURAL TUNNEL PKWY LOT 122","madd2":"","madd3":"","mcity":"DUFFIELD","mstate":"VA","mzip":"24244-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H25.813","H35.3131","D47.2","R06.2","M25.50","I69.393","R26.81","R53.1","M47.816","F33.9","H35.363","H25.812","L60.0","M46.1","I10","B35.1","M79.675","M79.674","L60.3","D48.5","J30.9","F10.21","Z00.00","D11.0","R06.00","R60.9","M62.81","H25.811","R51.9","M48.061","R07.9","R41.82","I12.9","M48.062","E53.8","M43.16","G83.12","N18.9","G89.29","E46","E66.9","E78.5","K21.9","U07.1","E66.3","R74.8","Z28.21","F17.210","M54.50","G82.20","N18.30","N18.31","R29.6","Z66","Z20.822","G83.9","E87.5","Z79.899","Z79.02","Z86.73","R29.818","R53.81"],"date":["2022-01-20","2022-01-20","2022-04-27","2022-02-03","2022-02-03","2022-02-03","2022-04-04","2022-04-04","2022-02-03","2022-02-03","2022-02-07","2022-03-01","2021-09-01","2021-11-03","2022-04-22","2021-10-11","2021-10-11","2021-10-11","2021-10-11","2021-10-12","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-12-15","2021-12-15","2021-12-15","2022-03-09","2022-04-04","2022-03-31","2022-04-04","2022-03-31","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2022-04-22","2022-04-22","2022-04-04","2021-11-03","2022-03-31","2022-04-01","2022-03-31","2022-04-04","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-04-01","2022-04-05"],"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":[["","65862035790","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","68180035302","SERTRALINE","TAB 100MG","45","Select","Select",""],["","00378668910","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00378001805","METOPROL","TAB 25MG","60","Select","Select",""],["","23155000201","HYDRALAZINE","TAB 25MG","90","Select","Select",""],["","69097094605","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","69097084607","CYCLOBENZAPR","TAB 10MG","63","Select","Select",""],["","10702001110","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","69315011610","FUROSEMIDE","TAB 20MG","10","Select","Select",""],["","43547035311","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","31722055190","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.50","Select","Select",""],["","00597008717","ATROVENT","AER 17MCG","12.90","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","14.00","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":""}]}]}