{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"P NIVEKYELSER","gend":0,"add":",6 TOL TRUOC TSERCLLIH 65                         ","city":"LEBANON                  ","state":"VA","zip":"24266-9998","dob":"1964-12-22","age":"","mstatus":"","insh":"10115535","cliId":"","pno":"4367208655","cno":"","email":"","ename":"","eno":"","pphy":"ALI, MUHAMMAD","ppno":2768838062,"pcpadd":"58 CARROLL ST RM 2037,","pcpcity":"Lebanon","pcpstate":"VA","pcpzip":24266,"pcpcounty":"","pcpid":"","pcpname":"BALLAD HEALTH  MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"56 HILLCREST COURT LOT 6,                         ","madd2":"                                                  ","madd3":"","mcity":"LEBANON                  ","mstate":"VA","mzip":"24266-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","Z79.84","Z79.4","D31.31","H40.023","I10","Z09","E11.65","R29.6","E78.5","R42","R26.89","I95.1","Z01.00","G43.909","G43.001","R50.9","R52","J20.9","J01.00","Z68.35","Z78.9","F32.9","Z76.89","F41.9","K21.9","G47.00","K76.0","Z91.19","H25.813","H04.123","F32.A","H53.2","R51.9","R26.81","G43.509","Z79.899","G43.501","E11.49","G52.9","Z91.199"," ","U07.1"],"date":["2022-11-08","2022-01-10","2022-11-08","2022-01-10","2022-01-10","2022-11-08","2022-11-08","2022-11-08","2021-07-29","2022-11-08","2021-01-29","2022-08-11","2021-03-04","2021-07-29","2021-11-04","2022-11-28","2022-11-16","2020-09-24","2020-09-24","2020-09-24","2020-10-23","2020-10-23","2020-10-23","2020-10-23","2022-11-08","2022-08-09","2020-10-23","2020-10-23","2022-03-21","2020-11-16","2020-11-16","2022-11-08","2022-08-09","2022-08-09","2022-08-09","2022-08-09","2022-08-09","2022-08-09","2022-11-28","2022-11-28","2022-11-08","2022-11-28","2022-11-16"],"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":[["","67877056305","METFORMIN","TAB 1000MG","180","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","36","Select","Select",""],["","69238111801","BUSPIRONE","TAB 15MG","60","Select","Select",""],["","51672404003","ENALAPRIL","TAB 20MG","90","Select","Select",""],["","00378668999","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","60505014202","GLIPIZIDE","TAB 10MG","180","Select","Select",""],["","00378395005","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","00193709021","CONTOUR","TES BLD GLUC","100","Select","Select",""],["","69034530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","16729018317","HYDROCHLOROT","TAB 25MG","90.00","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","300","Select","Select",""],["","50458014030","INVOKANA","TAB 100MG","90","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","20","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","10","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":""}]}]}