{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" G YDUJNOTLAD","gend":1,"add":"      DAOR NLIK EMIL 0102                         ","city":"FRIES                    ","state":"VA","zip":"24330-9998","dob":"1973-05-05","age":"","mstatus":"","insh":"10115582","cliId":"","pno":"4767280274","cno":2762350067,"email":"","ename":"","eno":"","pphy":"BONSU, OSEI A","ppno":2762368181,"pcpadd":"200 HOSPITAL DR,","pcpcity":"Galax","pcpstate":"VA","pcpzip":243332227,"pcpcounty":"","pcpid":"","pcpname":"GALAX FP IM TWIN COUNTY SVC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"2010 LIME KILN ROAD                               ","madd2":"                                                  ","madd3":"","mcity":"FRIES                    ","mstate":"VA","mzip":"24330-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z68.34","E11.9","R56.9","E78.5","E66.9","G80.9","F79","F41.9","K21.9","E78.1","Z91.09","F32.A","G40.909","E66.01","R45.86","F32.9","L71.9","Z23","D72.829","R23.2","F81.9","J30.9","Z79.84","Z97.3","F41.1","Z12.31","L23.7","Z30.42","E66.3","N95.1"," ","Z20.9","J09.X2"],"date":["2020-12-01","2022-07-25","2022-07-25","2022-07-25","2022-01-25","2022-07-25","2022-07-25","2022-01-25","2022-07-25","2022-07-25","2022-07-25","2022-01-25","2022-02-15","2022-07-25","2020-07-23","2022-02-15","2021-07-26","2022-10-31","2021-01-25","2021-01-25","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2022-10-31","2022-07-25","2022-07-14","2022-07-25","2022-07-25","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":{"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":[["","23155050110","HYDROXYZ","TAB 25MG","90","Select","Select",""],["","65862001305","SERTRALINE","TAB 100MG","90","Select","Select",""],["","62135098505","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","16729004417","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","45802011222","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","31722053712","LEVETIRACETA","TAB 500MG","180","Select","Select",""],["","69097045805","FENOFIBRATE","TAB 145MG","90","Select","Select",""],["","70010006310","METFORMIN","TAB 500MG","46","Select","Select",""],["","55111064505","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","51672411606","METRONIDAZOL","GEL 0.0075","45","Select","Select",""],["","16714099901","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","100","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA","50","Select","Select",""],["","08470104701","UNISTIK","MIS COMFORT","50","Select","Select",""],["","00527512170","NYSTATIN","SUS 100000","60","Select","Select",""],["","00832046560","NYAMYC","POW 100000","60","Select","Select",""],["","54981729","PREDNISONE","TAB 10MG","20","Select","Select",""],["","64380079901","OSELTAMIVIR","CAP 75MG","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}