{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"R AICILAZEUGIRDO","gend":1,"add":"  EVIRD DNALEROMTSEW 3711                         ","city":"HARRISONBURG             ","state":"VA","zip":"22801-9998","dob":"1959-06-21","age":"","mstatus":"","insh":"10116295","cliId":"","pno":"6504581090","cno":"","email":"","ename":"","eno":"","pphy":"MWANIKA, BENJAMIN I","ppno":5402981200,"pcpadd":"13737 SPOTSWOOD TRL,","pcpcity":"Elkton","pcpstate":"VA","pcpzip":228273200,"pcpcounty":"","pcpid":"","pcpname":"EAST ROCKINGHAM HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1173 WESTMORELAND DRIVE                           ","madd2":"                                                  ","madd3":"","mcity":"HARRISONBURG             ","mstate":"VA","mzip":"22801-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","G47.00","E78.2","K21.9","F43.21","R35.0","N39.46","R32","Z01.419","Z12.12","Z12.31","Z96.1","H35.30","E78.5","Z68.22","E78.00","Z76.89","B02.9","M25.461","M25.561","S82.034A","Z23","N39.41"," "],"date":["2022-11-23","2021-01-05","2022-11-23","2022-11-23","2021-01-05","2021-03-30","2022-05-11","2021-03-31","2020-09-10","2020-09-10","2020-09-10","2020-10-30","2020-11-25","2020-11-25","2020-11-25","2020-11-30","2020-11-30","2021-12-14","2021-12-06","2021-12-06","2021-12-06","2022-11-23","2022-05-11","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":[["","00469260130","MYRBETRIQ","TAB 25MG","30","Select","Select",""],["","65162022623","YUVAFEM","TAB 10MCG","26","Select","Select",""],["","00054014125","ACARBOSE","TAB 50MG","270","Select","Select",""],["","65862086001","FAMOTIDINE","TAB 40MG","90","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","60","Select","Select",""],["","70377000415","SIMVASTATIN","TAB 40MG","90","Select","Select",""],["","00006057761","JANUMET","TAB 50-1000","180","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","70461032003","FLUCLVX","INJ 2020-21","0.5","Select","Select",""],["","31722070530","VALACYCLOVIR","TAB 1GM","21","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":""}]}]}