{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" LORACHTAEH","gend":1,"add":"       RD RONAM EKAL 7641                         ","city":"FOREST                   ","state":"VA","zip":"24551-9998","dob":"1940-03-16","age":"","mstatus":"","insh":"10115915","cliId":"","pno":"0440810560","cno":8047494221,"email":"","ename":"","eno":"","pphy":"ADAMS, SCOTT B","ppno":4345254722,"pcpadd":"15421 FOREST ROAD,  ","pcpcity":"FOREST","pcpstate":"VA","pcpzip":245512274,"pcpcounty":"","pcpid":"","pcpname":"GRACE FAMILY MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1467 LAKE MANOR DR                                ","madd2":"                                                  ","madd3":"","mcity":"FOREST                   ","mstate":"VA","mzip":"24551-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.9","E78.5","E74.39","I10","D47.3","N39.41","M62.81","R41.89","R32","T45.2X1A","J45.909","G31.83","E55.9","R53.83","R06.00","Z23","F79","R26.89","R53.81","R62.7","Z91.81","F41.1","R73.03","Z87.891","R26.9","E66.9","Z68.35","N39.46","G30.9","N32.81","H81.4","D50.9","K21.9","M19.90","R06.2","R94.4","R73.9"],"date":["2022-08-02","2022-05-10","2022-05-03","2022-05-10","2022-05-10","2022-07-27","2022-07-27","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2021-08-10","2022-05-03","2020-09-04","2020-10-16","2020-09-04","2020-11-14","2020-10-16","2020-10-16","2020-10-16","2020-10-16","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2021-08-10","2021-08-04","2021-08-04"],"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":[["","49884072401","HYDROXYUREA","CAP 500MG","90","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","70377000215","SIMVASTATIN","TAB 10MG","90","Select","Select",""],["","50742061710","METOPROL","TAB 100MG ER","90","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","13668010390","DONEPEZIL","TAB 10MG","90","Select","Select",""],["","68462038730","SOLIFENACIN","TAB 10MG","90","Select","Select",""],["","65862020190","LOSARTAN","TAB 25MG","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":""}]}]}