{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"REFINNEJMAHDITS ","gend":1,"add":"  DR WOLLOH TTIMMURB 7555                         ","city":"NORTON                   ","state":"VA","zip":"24273-9998","dob":"1978-02-23","age":"","mstatus":"","insh":"10115308","cliId":"","pno":"1267251740","cno":2763250262,"email":"","ename":"","eno":"","pphy":"POWERS, MORGAN PAIGE","ppno":4235731502,"pcpadd":"2045 VALLEY VIEW DR,","pcpcity":"Big Stone Gap","pcpstate":"VA","pcpzip":242193319,"pcpcounty":"","pcpid":"","pcpname":"POST ACUTE CONSULTANTS OF VIRGINIA PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"5557 BRUMMITT HOLLOW RD                           ","madd2":"                                                  ","madd3":"","mcity":"NORTON                   ","mstate":"VA","mzip":"24273-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H16.223","Z83.511","H47.393","R94.112","R11.10","S09.90XA","S00.83XA","R51.9","R11.0","W22.8XXA","H53.8","R11.2","H53.149","S00.81XA","R42","E07.9","F17.210","H04.129","H52.03","H52.223","H52.4","H02.88A","H02.88B","R94.111","H40.003","E03.9","H40.1231"," "],"date":["2022-07-13","2022-02-10","2022-02-10","2022-01-14","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2021-10-02","2021-12-08","2021-12-08","2021-12-08","2021-12-08","2022-07-13","2022-07-13","2022-02-10","2022-03-15","2022-03-31","2022-04-28","2022-07-13"],"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":[["","00023916330","RESTASIS","EMU 0.05% OP","60","Select","Select",""],["","68180065001","DOXYCYC","CAP 50MG","180.00","Select","Select",""],["","24208071510","PRED","SOL 1% OP","10.00","Select","Select",""],["","24208046325","LATANOPROST","SOL 0.00005","2.50","Select","Select",""],["","00378180310","LEVOTHYROXIN","TAB 50MCG","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":["",""]}},{"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":""}]}]}