{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EWEJYTTEBGNORTS L","gend":1,"add":"       DAOR ANTERG W 0821                         ","city":"GRETNA                   ","state":"VA","zip":"24557-9998","dob":"1954-10-14","age":"","mstatus":"","insh":"10114120","cliId":"","pno":"7774364293","cno":"","email":"","ename":"","eno":"","pphy":"BLANKS, VIRGINIA L","ppno":4346561274,"pcpadd":"291 MCBRIDE LN,","pcpcity":"Gretna","pcpstate":"VA","pcpzip":245572773,"pcpcounty":"","pcpid":"","pcpname":"CMG GRETNA","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"UNIT A1                                           ","add3":"","madd1":"1280 W GRETNA ROAD                                ","madd2":"UNIT A1                                           ","madd3":"","mcity":"GRETNA                   ","mstate":"VA","mzip":"24557-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z51.81","M54.12","G89.4","Z79.891","M79.602","G56.03","G56.22","M50.30","M47.812","G56.23","G56.02","R14.0","R10.9","Z12.11","K58.1","Z23","K59.02","M54.2","M25.572","S82.832D","G89.29","F32.9","F41.9","G47.00","M50.322","M50.323","M62.838","M25.512","M47.22","Z01.818","M79.622","R25.2","Z82.49","K58.9","F17.210","G47.01","R53.1","R22.42","M50.21","M48.02","R10.84","K59.00","M50.31","H91.93","H61.23","H69.83"," ","M79.18"],"date":["2021-10-20","2022-11-17","2021-10-20","2021-10-20","2021-05-13","2021-07-30","2021-07-30","2021-06-10","2022-11-17","2021-06-10","2022-07-29","2022-08-02","2022-08-02","2022-09-30","2022-08-02","2020-09-23","2022-08-02","2022-11-17","2020-02-19","2020-02-19","2021-05-13","2020-11-04","2020-11-04","2020-06-17","2020-07-31","2022-10-04","2020-07-31","2020-11-18","2020-11-18","2021-09-24","2020-11-04","2020-11-11","2020-11-04","2020-11-04","2020-11-04","2020-11-11","2020-11-04","2020-11-04","2020-12-03","2020-12-03","2022-09-30","2022-09-30","2022-10-04","2022-09-19","2022-09-19","2022-10-11","2022-11-17","2022-11-17"],"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":[["","67877024760","QUETIAPINE","TAB 300MG","30","Select","Select",""],["","52268001201","SUPREP","SOL PREP KIT","354","Select","Select",""],["","00456120230","LINZESS","CAP 290MCG","30","Select","Select",""],["","13668000810","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","67877022205","GABAPENTIN","CAP 100MG","30","Select","Select",""],["","57664037718","TRAMADOL","TAB 50MG","30","Select","Select",""],["","00093506205","HYDROXYZ","TAB 50MG","60","Select","Select",""],["","59651039499","BACLOFEN","TAB 10MG","60","Select","Select",""],["","16729021716","SERTRALINE","TAB 100MG","60","Select","Select",""],["","16729044316","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","27808003503","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","00172392660","DIAZEPAM","TAB 5MG","10","Select","Select",""],["","59267030402","PFIZER","INJ BA4\/BA5","0.3","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","43547040010","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","61442011301","ACYCLOVIR","TAB 800MG","35","Select","Select",""],["","49281012165","FLUZONE","INJ 2021-22","0.7","Select","Select",""],["","62332014271","CELECOXIB","CAP 200MG","30","Select","Select",""],["","60505083305","AZELASTINE","SPR 0.001","30","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","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":""}]}]}