{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"R SALGUODEFFILCTA","gend":0,"add":"      EVIRD EDISNELG 6251                         ","city":"RICHMOND                 ","state":"VA","zip":"23226-9998","dob":"1952-07-23","age":"","mstatus":"","insh":"10114348","cliId":"","pno":"3240825439","cno":"","email":"","ename":"","eno":"","pphy":"ALI, SABINA","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":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1526 GLENSIDE DRIVE                               ","madd2":"                                                  ","madd3":"","mcity":"RICHMOND                 ","mstate":"VA","mzip":"23226-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R69","M54.59","I50.9","M17.0","M75.41","M75.42","M17.11","M17.12","N39.41","R39.14","N39.0","R32","I51.9","N31.9","R26.89","I10","E78.2","E66.01","Z12.5","M79.671","I89.0","M48.062","G47.33","Z12.11","Z28.21","I25.10","I50.32","I35.8","I51.7","I27.20","I48.0","I77.810","R60.0","Z01.812","Z20.822","D12.2","D12.3","Z86.010","K64.8","I11.0","K21.9","G89.29","Z68.38","Z79.52","Z79.82","Z79.899","K63.5","I25.118","I87.2","E66.9","M25.511","Z99.3","M25.512","Z74.1","Z00.00","Z71.89","Z28.20","Z13.5","M79.672","N18.31","M17.10","M77.8","K59.00","R26.9","I50.1"," ","M62.81","Z13.6","Z01.810","R07.9","R06.02","R53.81","Z87.891","I13.0","I08.0","M19.90","Z87.11","Z68.36","Z82.49","M48.00","I50.22","M17.9","N18.30","Z01.818","I25.110","I25.119","E55.9","Z68.35"],"date":["2022-03-04","2022-01-26","2022-02-24","2022-08-16","2021-09-22","2021-09-22","2021-10-18","2021-10-18","2021-09-22","2021-09-22","2021-09-22","2022-07-19","2022-07-19","2022-07-19","2022-07-19","2022-10-21","2021-10-20","2022-02-24","2022-10-19","2022-06-27","2022-08-16","2022-08-16","2022-11-08","2022-02-24","2021-10-20","2022-11-08","2022-08-16","2021-10-20","2021-10-20","2021-10-20","2022-10-21","2022-11-08","2021-10-20","2022-02-21","2022-02-21","2022-02-24","2022-02-24","2022-02-24","2022-02-24","2022-02-24","2022-11-08","2022-08-16","2022-06-27","2022-02-24","2022-02-24","2022-11-08","2022-02-24","2022-04-21","2022-10-21","2022-11-08","2022-04-04","2022-11-08","2022-04-04","2022-08-08","2022-06-27","2022-06-27","2022-06-27","2022-06-27","2022-06-27","2022-11-08","2022-07-20","2022-07-20","2022-07-20","2022-10-10","2022-11-08","2022-11-14","2022-08-16","2022-10-31","2022-11-09","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-10-10","2022-10-10","2022-10-10","2022-10-10","2022-11-09","2022-10-21","2022-11-14","2022-10-19","2022-11-14"],"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":[["","50228018010","GABAPENTIN","CAP 300MG","180","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","270","Select","Select",""],["","00832532511","POT  CL MICRO","TAB 20MEQ ER","90","Select","Select",""],["","58657067601","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","60505471403","CARVEDILOL","CAP 20MG ER","90","Select","Select",""],["","52268001201","SUPREP","SOL PREP KIT","354.00","Select","Select",""],["","68462063945","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","13668010401","ISOSORB","TAB 30MG ER","90","Select","Select",""],["","72205000530","ROSUVASTATIN","TAB 40MG","90","Select","Select",""],["","64764017130","DEXILANT","CAP 30MG DR","90","Select","Select",""],["","591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00469260130","MYRBETRIQ","TAB 25MG","90","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":""}]}]}