{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AROM MAILLIWODEVECA SEL","gend":0,"add":" DOOW 94NL KRAP","city":"WOODSTOCK                ","state":"VA","zip":"22664-9998","dob":"1959-08-01","age":"","mstatus":"","insh":"10114446","cliId":"","pno":"3304556535","cno":5403254918,"email":"","ename":"","eno":"","pphy":"CUNNINGHAM, JENNIFER D","ppno":5404773808,"pcpadd":"5173 MAIN ST,","pcpcity":"Mount Jackson","pcpstate":"VA","pcpzip":228429513,"pcpcounty":"","pcpid":"","pcpname":"MT JACKSON FAMILY HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"PO BOX 10","madd2":"                                                  ","madd3":"","mcity":"WOODSTOCK                ","mstate":"VA","mzip":"22664-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.41","I10","G89.29","K59.04","E78.2","R73.09","Z87.39","H01.003","H01.006","H52.13","Z71.6","F17.200","Z12.2","M54.42","E78.49","B18.2","Z90.5","Z53.20","Z12.5","Z86.59","F32.89"],"date":["2022-06-02","2022-04-11","2022-06-02","2022-04-01","2020-10-01","2020-10-01","2021-10-15","2020-11-03","2020-11-03","2020-11-03","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-11","2022-04-11","2022-04-01","2022-04-01","2022-04-11","2022-06-02","2022-06-02"],"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":[["","65862052305","GABAPENTIN","TAB 600MG","120","Select","Select",""],["","31722073090","IRBESARTAN","TAB 150MG","90","Select","Select",""],["","70954005920","PREDNISONE","TAB 10MG","30","Select","Select",""],["","68382056401","METOPROL","TAB 25MG ER","90","Select","Select",""],["","53746051401","SPIRONOLACT","TAB 50MG","90","Select","Select",""],["","70377000315","SIMVASTATIN","TAB 20MG","90","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","21","Select","Select",""],["","57237004105","PENICILLN","TAB 500MG","30","Select","Select",""],["","69097096507","NABUMETONE","TAB 500MG","60","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","21","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":""}]}]}