{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" RETSELKOOH B","gend":0,"add":"KCAB 1853DR KEERC ","city":"GORE","state":"VA","zip":"22637-9998","dob":"1952-03-13","age":"","mstatus":"","insh":"10114721","cliId":"","pno":"0304520823","cno":"","email":"","ename":"","eno":"","pphy":"GRANT, JOEL T","ppno":5408684100,"pcpadd":"160 Warrior Dr, ","pcpcity":"Stephens City","pcpstate":"VA","pcpzip":226554044,"pcpcounty":"","pcpid":"","pcpname":"STEPHENS CITY FAMILY MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"3581 BACK CREEK RD","madd2":"","madd3":"","mcity":"GORE","mstate":"VA","mzip":"22637-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.81","M47.892","M54.2","D17.0","M47.812","R22.1","I35.1","I50.32","I25.10","I10","E78.5","J44.9","R91.1","E78.2","M1A.00X0","J02.9","J03.90","I73.9","Z79.899","J43.2","I70.0","Z00.00","N18.2","G44.209","R03.0","Z03.818","R06.02","Z20.828","R05","J98.4","Z12.2","Z87.891","Z87.81","J43.9","R91.8","J18.9","M79.18","R51","M10.9","R09.82","I50.9","I35.0","J44.1","Z20.822","N17.9","I12.9","R51.9","Z86.73","K82.4","R94.4","R09.02"],"date":["2022-01-04","2021-03-09","2021-10-05","2020-02-04","2020-02-04","2020-02-04","2021-11-29","2021-09-03","2021-11-11","2021-11-29","2021-09-03","2021-12-17","2021-09-07","2021-11-29","2021-11-29","2021-04-21","2020-03-02","2021-03-30","2021-03-09","2021-09-07","2021-09-07","2021-04-08","2021-10-28","2020-04-16","2020-04-16","2021-04-21","2021-10-11","2021-12-28","2021-05-12","2021-12-17","2021-09-07","2021-06-02","2021-06-02","2021-06-02","2021-12-17","2021-06-21","2021-10-05","2020-07-16","2021-11-22","2021-07-27","2021-09-03","2021-09-07","2021-10-11","2021-10-11","2021-10-28","2021-10-28","2021-11-11","2021-11-11","2021-11-22","2021-11-29","2021-12-17"],"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":[["","50111032701","HYDRALAZINE","TAB 25MG","60","Select","Select",""],["","69097068205","PREGABALIN","CAP 150MG","60","Select","Select",""],["","00173071920","FLOVENT","AER 110MCG","36","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","180","Select","Select",""],["","68382009505","CARVEDILOL","TAB 25MG","180","Select","Select",""],["","00487950125","ALBUTEROL","NEB 0.00083","150","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","68645048154","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","16729009016","FINASTERIDE","TAB 5MG","90","Select","Select",""],["","00597002402","COMBIVENT","AER 20-100","4","Select","Select",""],["","72124000201","TUDORZA","AER 400\/ACT","3","Select","Select",""],["","00173089310","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","68462063945","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","16714004107","ALLOPURINOL","TAB 100MG","270","Select","Select",""],["","68462030201","INDOMETHACIN","CAP 50MG","90","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","7","Select","Select",""],["","00597008717","ATROVENT","AER 17MCG","38.7","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","20","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","15","Select","Select",""],["","69097084053","IPRATROPIUM\/","SOL ALBUTER","1,080.00","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","20","Select","Select",""],["","49281012165","FLUZONE","INJ 2021-22","0.7","Select","Select",""],["","00000000000","LIDOCAINE","SOL 2% VISC","180","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":""}]}]}