{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"R R ARUALNOTGNIME","gend":1,"add":"      ENAL SEDOHR NOLE 12                         ","city":"HARRISONBURG             ","state":"VA","zip":"22802-9998","dob":"1961-03-01","age":"","mstatus":"","insh":"10113620","cliId":"","pno":"1804584980","cno":"","email":"","ename":"","eno":"","pphy":"BURRI, CHRISTOPHER A","ppno":5404332623,"pcpadd":"1225 RESERVOIR ST,PO BOX 169","pcpcity":"Harrisonburg","pcpstate":"VA","pcpzip":228014415,"pcpcounty":"","pcpid":"","pcpname":"HARRISONBURG HEALTH AND REHAB CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"21 ELON RHODES LANE Apt 105                       ","madd2":"                                                  ","madd3":"","mcity":"HARRISONBURG             ","mstate":"VA","mzip":"22802-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","N32.9","R39.81","N39.46","N39.41","N39.3","F25.9","K59.01","K59.00","R03.0","R29.2","Z79.899","R68.2","Z23","R07.89","E78.1","R73.03","E55.9","M17.0","M54.5","D69.9","F29","Z87.891","Z88.8","Z88.6","Z20.822","Z03.818","Z12.31","Z11.59","Z11.4","E87.1","I31.3","R09.02","D72.829","J20.9","I50.9","I50.33","J96.21","J43.2","R79.89","E83.42","E78.5","K44.9","G47.00","I49.8","I49.1","R94.31","I51.7","R05.9","R18.8","R06.02","R91.8","F39","F23","F41.9","R07.9","R53.1","M25.561","M25.562","M17.11","M17.12","Z00.00","M54.2","R25.2","J44.9","L21.9","J02.9","R05","F51.01","N94.9","G47.09","Z72.821","R06.83","B35.1","R20.2","G62.9","Z82.49","G44.89","Z13.30","Z75.1","Z91.09","Z04.9","R45.1","F17.210","G80.9","F02.80","G30.9","I10","Z04.6"," ","Z91.14","Z78.9","R42"],"date":["2022-10-31","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-10-17","2020-09-01","2022-02-11","2022-02-11","2022-02-11","2022-09-10","2021-09-21","2022-10-17","2021-05-11","2022-02-11","2022-04-29","2022-02-11","2022-02-11","2021-09-21","2022-01-31","2022-07-12","2022-07-16","2022-09-10","2022-09-07","2022-09-07","2022-10-31","2021-02-16","2020-10-30","2020-10-30","2021-11-23","2021-11-19","2022-03-24","2021-11-19","2021-11-08","2021-11-08","2022-02-11","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2022-10-17","2021-11-19","2021-11-13","2021-11-19","2021-11-09","2021-11-08","2021-11-14","2021-11-17","2021-11-14","2020-11-16","2022-10-31","2022-09-10","2022-07-12","2021-03-10","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2021-01-18","2021-01-18","2020-04-21","2022-02-11","2022-02-11","2021-02-19","2021-02-19","2021-04-05","2021-02-26","2021-03-10","2022-04-13","2022-04-13","2021-07-20","2022-03-24","2022-03-24","2022-07-12","2022-03-24","2022-07-12","2022-07-12","2022-07-12","2022-08-19","2022-09-07","2022-09-07","2022-09-10","2022-07-16","2022-07-16","2022-07-16","2022-09-07","2022-10-31","2022-10-31","2022-10-31","2022-10-17"],"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":[["","50458056401","INVEGA","INJ 234\/1.5","1.5","Select","Select",""],["","16729013800","CLONAZEPAM","TAB 2MG","60","Select","Select",""],["","58657070401","HALOPERIDOL","TAB 10MG","30.00","Select","Select",""],["","70010002803","RAMELTEON","TAB 8MG","30.00","Select","Select",""],["","33342030111","ESZOPICLONE","TAB 3MG","30","Select","Select",""],["","57237000830","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","16729014801","QUETIAPINE","TAB 200MG","30","Select","Select",""],["","00603243832","BENZTROPINE","TAB 1MG","60","Select","Select",""],["","68382080605","TRAZODONE","TAB 100MG","13","Select","Select",""],["","43975035003","PALIPERIDONE","TAB ER 3MG","30","Select","Select",""],["","65862001701","AMOXICILLIN","CAP 500MG","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":["",""],"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":""}]}]}