{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" HNYUHNART T","gend":1,"add":"DER 422NL DAEM","city":"NORTH CHESTERFIELD","state":"VA","zip":"23236-9998","dob":"1941-11-11","age":"","mstatus":"","insh":"10114157","cliId":"","pno":"9240837209","cno":"","email":"","ename":"","eno":"","pphy":"MIRSHAHI, IRAJ","ppno":8046732814,"pcpadd":"5855 BREMO RD STE 102,","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232261926,"pcpcounty":"","pcpid":"","pcpname":"MONUMENT INTERNAL MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"N","ano":"","add2":"                                                  ","add3":"","madd1":"224 REDMEAD LN","madd2":"                                                  ","madd3":"","mcity":"NORTH CHESTERFIELD","mstate":"VA","mzip":"23236-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","M17.0","I25.118","I25.10","E78.00","M65.341","Z01.812","Z20.822","R07.9","R94.39","E78.5","Z79.899","Z79.02","R07.89","R06.02","Z68.26","R06.01","Z95.5","I08.3","I77.810","I50.31","R53.83","R68.89","Z23","Z68.25","K21.9","I11.9","R93.89","R07.81","J98.4","I51.7","M17.11","M17.12","E55.9","R11.2","Z74.3","R91.8","R53.1","R06.00","S23.41XA"],"date":["2022-07-13","2022-07-13","2022-01-25","2022-01-25","2022-07-13","2022-01-25","2021-09-15","2021-09-15","2022-07-20","2021-09-20","2021-09-20","2021-09-20","2021-09-20","2021-09-20","2022-07-13","2022-07-13","2021-12-21","2022-07-13","2021-12-28","2021-12-28","2021-12-28","2022-07-13","2021-12-28","2021-12-29","2021-12-29","2021-12-29","2021-09-02","2022-07-20","2022-07-13","2022-07-13","2022-07-13","2022-07-13","2022-07-13","2022-07-13","2022-06-25","2022-06-25","2022-07-13","2022-06-25","2022-06-25","2022-07-07"],"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":[["","68382050010","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","90","Select","Select",""],["","65862035705","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","68462034690","LEVOCETIRIZI","TAB 5MG","90","Select","Select",""],["","68382065005","ISOSORB","TAB 30MG ER","90","Select","Select",""],["","43598043601","NITROGLYCERN","SUB 0.4MG","100","Select","Select",""],["","68462074635","ACYCLOVIR","OIN 0.05","30","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","33342018010","OLMESA","TAB 40MG","90","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","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":""}]}]}