{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"L SEMAJHTIMS ","gend":0,"add":"     ENAL  SGNINNEJ 65201                         ","city":"HAYES                    ","state":"VA","zip":"23072-9998","dob":"1950-01-06","age":"","mstatus":"","insh":"10115894","cliId":"","pno":"4475777349","cno":7574494377,"email":"","ename":"","eno":"","pphy":"MOYLAN, BRIAN L","ppno":8046426171,"pcpadd":"2246 GEORGE WASHINGTON HIGHWAY,STE C","pcpcity":"HAYES","pcpstate":"VA","pcpzip":230614351,"pcpcounty":"","pcpid":"","pcpname":"RIVERSIDE HAYES MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"10256 JENNINGS  LANE                              ","madd2":"                                                  ","madd3":"","mcity":"HAYES                    ","mstate":"VA","mzip":"23072-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","D64.9","R94.6","Z00.00","I44.4","F17.210","R00.0","R09.89","I73.9","Z91.81","Z91.19","R32","R79.89","M25.512","R42","Z91.14","R07.81","W19.XXXA","N28.9","W10.8XXD","J41.0","F17.200","Z71.6","R07.9","M54.50"," "],"date":["2022-08-24","2022-08-24","2022-01-14","2022-01-14","2022-01-28","2022-05-18","2022-01-28","2022-02-09","2022-02-09","2022-01-28","2022-01-28","2021-02-22","2021-05-26","2021-05-26","2020-08-03","2020-08-03","2020-10-09","2020-09-26","2020-09-30","2020-10-09","2022-05-18","2022-08-24","2021-10-27","2020-11-09","2022-04-26","2022-08-24"],"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":[["","43547033810","BENAZEPRIL","TAB 40MG","90","Select","Select",""],["","00378087199","CLONIDINE","DIS 0.1\/24HR","4","Select","Select",""],["","00591288601","VERAPAMIL","CAP 360MG SR","90","Select","Select",""],["","70461012003","FLUAD","INJ 0.5ML","0.5","Select","Select",""],["","59746017306","PREDNISONE","TAB 10MG","14","Select","Select",""],["","29300041301","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","16571020110","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","49281012265","FLUZONE","INJ 2022-23","0.7","Select","Select",""],["","69238110005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","65162003310","APAP\/CODEINE","TAB 300-30MG","30","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}