{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"R DLORAHNOSNIBO","gend":0,"add":"           EIDDIWNID 1761                         ","city":"PETERSBURG               ","state":"VA","zip":"23803-9998","dob":"1955-08-17","age":"","mstatus":"","insh":"10115249","cliId":"","pno":"8940840828","cno":8042556277,"email":"","ename":"","eno":"","pphy":"BREWER, STEVEN","ppno":8048830052,"pcpadd":"16618 MOUNTAIN RD STE B,","pcpcity":"Montpelier","pcpstate":"VA","pcpzip":231922649,"pcpcounty":"","pcpid":"","pcpname":"CARE NOW INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"316 E Fillmore St                                 ","madd2":"                                                  ","madd3":"","mcity":"Petersburg               ","mstate":"VA","mzip":"23803-5148","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E66.01","Z68.42","I83.892","I83.12","R68.89","I25.10","Z95.1","M79.609","I87.8","R53.1","R60.1","R26.2","R07.9","R06.02","R60.0","I25.5","Z95.5","M96.1"," ","I10","I50.22","E87.6","R73.09","D64.9","E78.00","G89.29","F17.200","M54.51","Z79.891","Z51.81","M47.817"],"date":["2022-04-14","2022-12-07","2022-09-28","2022-09-28","2022-06-15","2022-06-28","2022-07-11","2022-06-28","2022-06-28","2022-12-12","2022-06-28","2022-04-01","2022-07-11","2022-07-11","2022-09-28","2022-07-11","2022-07-11","2022-10-21","2022-12-12","2022-12-07","2022-12-07","2022-12-07","2022-12-07","2022-12-07","2022-12-07","2022-12-07","2022-12-07","2022-11-10","2022-11-10","2022-11-10","2022-11-10"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":[["","00054430125","FUROSEMIDE","TAB 80MG","30","Select","Select",""],["","65862078430","ESOMEPRA","CAP 40MG DR","30","Select","Select",""],["","68462016505","CARVEDILOL","TAB 25MG","60","Select","Select",""],["","45963055650","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","68180051202","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","00406012505","HYDROCO\/APAP","TAB 10-325MG","45","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","68382039801","POT  CHLORIDE","TAB 20MEQ ER","90","Select","Select",""],["","00093206506","CILOSTAZOL","TAB 50MG","30","Select","Select",""],["","65862035705","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","69097067805","PREGABALIN","CAP 50MG","60","Select","Select",""],["","00143301801","COLCHICINE","CAP 0.6MG","90","Select","Select",""],["","406052201","OXYCOD\/APAP","TAB 7.5-325","90","Select","Select",""],["","55111012305","ATORVASTATIN","TAB 40MG","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":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}