{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAMMAHOMMEESAW ","gend":0,"add":"    ENAL EVRUC SPIHS 3518                         ","city":"SPRINGFIELD              ","state":"VA","zip":"22153-9998","dob":"1945-01-01","age":"","mstatus":"","insh":"10114026","cliId":"","pno":"3217599180","cno":"","email":"","ename":"","eno":"","pphy":"SINGH, GURWINDER","ppno":7579846170,"pcpadd":"4374 NEW TOWN AVE STE 102,  ","pcpcity":"Williamsburg","pcpstate":"VA","pcpzip":231882865,"pcpcounty":"","pcpid":"","pcpname":"SENTARA INTERNAL MEDICINE PHYSICIANS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1505 Forest Ln                                    ","madd2":"                                                  ","madd3":"","mcity":"Woodbridge               ","mstate":"VA","mzip":"22191-3025","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["ASIAN\/PACIFIC"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M99.03","M99.02","M99.04","M54.59","M54.6","M53.3","M79.10","M79.2","M48.061","I10","Z23","M1A.39X0","E78.2","K21.9","S86.912S","M47.26","N40.1","Z11.59","H57.9","R35.1","M54.42","Z91.81","B36.9","M54.41","G89.29","K59.00","M62.838","H04.123","M1A.09X0","Z11.52","Z91.19","R07.9","H43.392","G62.9","R41.3","R25.1","R26.9","Z20.828","M47.816"],"date":["2022-02-11","2022-02-11","2022-02-11","2022-02-11","2022-02-11","2022-02-11","2022-02-11","2022-02-11","2022-06-14","2022-06-14","2022-01-21","2021-09-21","2022-06-14","2021-09-21","2021-09-21","2022-06-14","2021-09-21","2021-09-21","2021-09-21","2021-09-21","2022-06-14","2022-01-21","2022-01-21","2022-06-14","2022-06-14","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2022-02-11","2022-06-14","2020-11-03","2020-11-03","2020-11-16","2020-11-16","2020-11-16","2020-11-16","2022-02-09","2021-09-08"],"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":[["","70377002811","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","15","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","90","Select","Select",""],["","31722054301","INDOMETHACIN","CAP 50MG","30","Select","Select",""],["","16729009016","FINASTERIDE","TAB 5MG","90","Select","Select",""],["","76385012350","METHOCARBAM","TAB 500MG","30","Select","Select",""],["","24208029505","TOBRA\/DEXAME","SUS 0.3-0.1%","5","Select","Select",""],["","67877045005","TAMSULOSIN","CAP 0.4MG","90","Select","Select",""],["","16729013401","ALLOPURINOL","TAB 100MG","90","Select","Select",""],["","53746054401","PRIMIDONE","TAB 50MG","90","Select","Select",""],["","10702000601","CYCLOBENZAPR","TAB 5MG","60","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","68462019001","NAPROXEN","TAB 500MG","60","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","40","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":""}]}]}