{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YERDUALRAEP S","gend":1,"add":"       nL dleifremmuS 869                         ","city":"Winchester               ","state":"VA","zip":"22601-2791","dob":"1937-11-10","age":"","mstatus":"","insh":"10115611","cliId":"","pno":"3404510411","cno":5405324654,"email":"","ename":"","eno":"","pphy":"FLACK, DAVID","ppno":5406782800,"pcpadd":"104 SELMA DR,STE 101","pcpcity":"Winchester","pcpstate":"VA","pcpzip":226013834,"pcpcounty":"","pcpid":"","pcpname":"SELMA MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"968 Summerfield Ln                                ","madd2":"                                                  ","madd3":"","mcity":"Winchester               ","mstate":"VA","mzip":"22601-2791","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.9","L40.0","K04.7","I50.9","G47.33","M77.40","M27.0","R06.7","R05","G47.30","J34.2","R09.82","I10","R54","L98.9","M77.41","M77.42","R60.9","D22.4","L25.9","Z23","L40.9","Q82.8","H91.90","Z79.82","Z97.3","Z85.118","Z90.2","E78.5","K21.9","M16.12","E66.01","Z87.891","L84","G89.4","Z68.39","Z96.1","H40.1133","E78.2","I25.10","E87.6","D64.9","M20.41","M20.42","L30.8","M20.11","M20.12","H35.3132"," "],"date":["2022-10-05","2022-07-27","2022-01-10","2022-10-05","2022-11-23","2020-02-13","2020-02-19","2020-02-19","2020-02-19","2020-02-19","2020-02-19","2020-02-19","2022-10-05","2022-10-05","2021-03-18","2022-06-23","2022-06-23","2020-06-24","2021-07-21","2021-09-02","2022-10-05","2022-06-23","2021-11-11","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2022-10-05","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2020-11-12","2021-12-30","2022-11-14","2022-03-16","2022-10-05","2022-10-05","2022-10-05","2022-06-23","2022-06-23","2022-03-24","2022-06-23","2022-06-23","2022-11-14","2022-11-23"],"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":[["","00143983610","PENICILLN","TAB 500MG","28.00","Select","Select",""],["","00378827052","ALBUTEROL","NEB 0.00083","75","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","180","Select","Select",""],["","00023921105","COMBIGAN","SOL 0.2\/0.5%","5","Select","Select",""],["","00074204202","SKYRIZI","INJ 150DOSE","1","Select","Select",""],["","00002144511","TALTZ","INJ 80MG\/ML","1","Select","Select",""],["","00168005615","BETAMETH","OIN 0.0005","15","Select","Select",""],["","68682099798","DILTIAZEM","CAP 240MG ER","90","Select","Select",""],["","68462030047","ALCLOMETASON","CRE 0.0005","45","Select","Select",""],["","59746036290","VALSARTAN","TAB 160MG","90","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","5.00","Select","Select",""],["","13668042990","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00093321930","KETOCONAZOLE","CRE 0.02","30","Select","Select",""],["","53746054201","POT  CHLORIDE","CAP 10MEQ ER","180","Select","Select",""],["","24208046325","LATANOPROST","SOL 0.00005","7.5","Select","Select",""],["","68180071909","AMLODIPINE","TAB 2.5MG","30.00","Select","Select",""],["","00832054211","BUMETANIDE","TAB 2MG","180","Select","Select",""],["","60505017009","PRAVASTATIN","TAB 40MG","90","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","40","Select","Select",""],["","68382074716","TIADYLT","CAP 240MG\/24","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":""}]}]}