{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"W YDUJTHGIR","gend":1,"add":" 81 TPA DR  ELADNELG 9411                         ","city":"GALAX                    ","state":"VA","zip":"24333-9998","dob":"1952-09-19","age":"","mstatus":"","insh":"10116400","cliId":"","pno":"3267280146","cno":"","email":"","ename":"","eno":"","pphy":"GARLAND, JEFFREY S","ppno":2762380911,"pcpadd":"2851 CARROLLTON PIKE STE A5,STE A3","pcpcity":"Woodlawn","pcpstate":"VA","pcpzip":243813664,"pcpcounty":"","pcpid":"","pcpname":"MID ATLANTIC QUICKCARE PLLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1149 GLENDALE  RD APT 18                          ","madd2":"                                                  ","madd3":"","mcity":"GALAX                    ","mstate":"VA","mzip":"24333-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L82.1","U07.1","B34.9","R05.9","Z12.31","E11.9","G35","E78.2","F41.9","I10","M81.0","C34.90","H91.93","M54.5","Z86.010","D37.4","K31.89","K44.9","J20.9","J30.9","R30.9","M54.50","B37.2","L84","L60.0","E11.51","H61.23","Z00.01","Z00.00","R89.9","R94.5","C34.12","I89.0","E55.9","E80.7","C34.2","Z87.891","Z08","J43.9","K76.0","Z85.118","Z92.21","Z92.3","Z98.890","Z79.899","L98.9","R79.9","L82.0","D48.5","D18.01","L53.8","R20.8","L29.8","D23.72","D04.71","Z96.1","C44.722","K31.7","K21.9","K29.50","K21.0","D12.2","K57.30","E66.9","M19.90","Z88.0","Z88.1","R58","Z48.817","L81.4","Z23","R13.10","K22.2","K29.70","K21.00","Z90.49","Z90.710","Z88.8","Z83.71","E78.5","F41.1","L90.5","R15.2","Z78.0","B35.1","M79.675","M79.674","M85.80"," ","I35.8","I51.7","I51.89","R07.9","R06.02","R01.1","I20.9","I12.9","N18.30","J44.9","D69.6","E83.51","I70.90","N18.31","I13.10","C34.92","E88.81","Z85.828","R91.8","I20.8"],"date":["2022-05-18","2022-01-12","2022-01-12","2022-01-12","2022-05-17","2022-12-02","2022-06-01","2022-10-24","2022-06-01","2022-11-28","2022-06-29","2022-06-01","2022-06-01","2021-05-26","2020-08-17","2020-07-28","2020-07-28","2021-12-22","2020-02-25","2020-02-25","2022-03-01","2022-06-01","2022-03-01","2022-10-17","2022-03-21","2022-03-21","2021-12-10","2022-06-01","2020-05-13","2021-05-26","2021-06-15","2022-12-06","2022-10-10","2022-10-10","2021-07-01","2022-09-11","2022-12-06","2022-09-09","2021-07-01","2021-07-01","2021-12-22","2021-07-01","2021-07-01","2021-07-01","2021-12-22","2021-07-08","2020-07-10","2022-09-29","2021-08-25","2022-09-09","2022-09-09","2021-07-16","2021-09-08","2021-07-30","2021-07-30","2021-08-03","2021-08-11","2021-12-22","2021-12-22","2021-12-22","2020-08-17","2020-08-17","2020-08-17","2020-08-14","2020-08-14","2021-12-22","2020-08-14","2021-08-25","2021-08-25","2021-09-08","2022-11-28","2021-12-22","2021-12-22","2021-12-22","2021-12-22","2021-12-22","2021-12-22","2021-12-22","2021-12-22","2022-11-28","2021-03-25","2022-09-09","2022-06-01","2022-06-29","2022-10-17","2022-10-17","2022-10-17","2022-06-29","2022-12-06","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-10-24","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2022-12-02","2022-10-17","2022-10-24","2022-10-10","2022-10-10","2022-10-24","2022-09-09","2022-10-07","2022-10-07"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":[["","00093505998","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","68645019059","METOPROL","TAB 50MG","30","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","MIS LANCETS","100","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","100","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","21","Select","Select",""],["","99073070805","FREESTYLE    MIS LITE","MIS LITE","1","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","45802005935","NYSTATIN","CRE 100000","15","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","6.00","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","93342501","LORAZEPAM","TAB 0.5MG","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}