{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YELNATSYLEVIL W","gend":0,"add":"          RT LLAF RAEB 13                         ","city":"HOWARDSVILLE             ","state":"VA","zip":"24562-9998","dob":"1971-10-17","age":"","mstatus":"","insh":"10115398","cliId":"","pno":"0943428556","cno":"","email":"","ename":"","eno":"","pphy":"HEDIAN, KATHERINE ADELICIA","ppno":4342863602,"pcpadd":"2256 IRISH RD,","pcpcity":"Esmont","pcpstate":"VA","pcpzip":229371945,"pcpcounty":"","pcpid":"","pcpname":"SOUTHERN ALBEMARLE FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"31 BEAR FALL TR                                   ","madd2":"                                                  ","madd3":"","mcity":"HOWARDSVILLE             ","mstate":"VA","mzip":"24562-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25.572","M25.512","M54.2","S49.92XA","M25.519","M79.642","M19.032","M75.112","M67.912","M19.012","R68.89","R53.83","R06.2","M25.472","M25.432","M54.9","Z71.3","Z71.89","Z01.30","M62.81","M79.672","M79.89","M25.532","J43.9","E55.9","M75.82","R93.7","M24.812","M65.812","M79.645","M18.12","M25.649","G89.29","J45.909","R07.9"," ","K80.20","K76.0","R20.0","R16.1","J40","N28.1","E78.5","J44.9","Z72.0","I25.10","R20.2","R06.02","F17.210","Z82.49"],"date":["2022-02-09","2022-07-12","2022-03-09","2022-03-09","2022-03-16","2022-09-19","2022-09-28","2022-06-04","2022-06-04","2022-06-13","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-05-17","2022-05-03","2022-05-03","2022-05-03","2022-05-17","2022-05-17","2022-05-17","2022-08-10","2022-10-27","2022-12-02","2022-05-17","2022-06-13","2022-05-23","2022-06-04","2022-06-04","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-09-28","2022-12-02","2022-12-05","2022-12-05","2022-12-05","2022-12-03","2022-12-03","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2022-12-01","2022-11-17","2022-12-01","2022-12-01","2022-12-01"],"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":[["","65862056090","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","13668008105","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","5","Select","Select",""],["","69097094405","ATORVASTATIN","TAB 10MG","90.00","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","18","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","47781019605","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","57664037718","TRAMADOL","TAB 50MG","20","Select","Select",""],["","65162004710","OXYCODONE","TAB 5MG","5.00","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","10.00","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":""}]}]}