{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"M NONNAHSREHGLUD ","gend":1,"add":"TPA ENAL KRAP NEDRAG 5127                     302 ","city":"MECHANICSVILLE           ","state":"VA","zip":"23111-9998","dob":"1977-11-26","age":"","mstatus":"","insh":"10113541","cliId":"","pno":"0675767798","cno":7576089776,"email":"","ename":"","eno":"","pphy":"VARMA, KANIKA","ppno":8047463505,"pcpadd":"7041 LEE PARK RD,","pcpcity":"Mechanicsville","pcpstate":"VA","pcpzip":231113682,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS PRIMARY CARE ASSOCIATES - MECHANICSVIL","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"7215 GARDEN PARK LANE APT 203                     ","madd2":"                                                  ","madd3":"","mcity":"MECHANICSVILLE           ","mstate":"VA","mzip":"23111-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.65","E11.42","E55.9","Z79.84","H10.9","H57.89","E11.9","I10","E78.5","J45.909","Z87.891","Z79.51","J06.9","R05","R09.81","J01.90","F17.200","E78.1","Z23","Z00.00","Z68.32","Z79.4","Z12.31","E66.01","N39.0","J32.9","E11.21","R79.89","L03.032","L08.9","Z68.36","E78.00","Z13.29","S99.922A","E11.22","N18.31","Z68.35","R07.81","S29.9XXA","W01.0XXA","Y93.01","Y92.410","S22.31XA","R05.9","Z20.822","S39.012A","M54.50","M79.89","M79.605","X58.XXXA","M54.16","M51.37","R00.0","E86.0","N30.01","R22.42","M54.9","R73.9","B37.41","A60.00"," "],"date":["2021-03-03","2021-07-02","2021-07-02","2022-09-07","2022-07-29","2021-01-23","2022-09-07","2022-09-10","2022-09-04","2022-09-10","2022-09-04","2022-03-04","2020-02-19","2020-03-01","2022-07-29","2020-02-19","2022-09-07","2021-02-25","2021-02-25","2021-02-25","2021-02-25","2021-03-03","2021-02-25","2021-02-25","2021-02-25","2020-03-01","2021-07-02","2022-09-10","2020-10-10","2020-10-10","2020-11-12","2022-09-10","2020-11-12","2020-11-12","2020-12-10","2020-12-10","2020-12-16","2022-03-04","2022-03-04","2022-03-04","2022-03-04","2022-03-04","2022-03-04","2022-07-29","2022-07-29","2022-09-07","2022-09-10","2022-09-12","2022-09-07","2022-09-07","2022-09-04","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-10","2022-09-12"],"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":[["","53885024510","ONETOUCH","TES ULTRA","100","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","90","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","76385012350","METHOCARBAM","TAB 500MG","12","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","68382075810","METFORMIN","TAB 500MG","180","Select","Select",""],["","24208031510","POLYMYXIN","SOL TRIMETHP","10","Select","Select",""],["","49483060350","IBUPROFEN","TAB 600MG","15","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","00169406013","VICTOZA","INJ 18MG\/3ML","9","Select","Select",""],["","70377000812","ROSUVASTATIN","TAB 20MG","90","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","68462030529","NORETHINDRON","TAB 0.35MG","84","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","20","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","20","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","60505056000","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","20","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":""}]}]}