{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"M AIRAMAZODNE","gend":1,"add":"LEB 0081RD SWOL","city":"RICHMOND","state":"VA","zip":"23225-9998","dob":"1944-01-12","age":"","mstatus":"","insh":"10116415","cliId":"","pno":"4740807215","cno":"","email":"","ename":"","eno":"","pphy":"REHMAN, SYED A","ppno":"7575362246          ","pcpadd":"500 Hioaks Rd, Ste B","pcpcity":"500 Hioaks Rd, Ste B","pcpstate":"VA","pcpzip":"232254061","pcpcounty":"","pcpid":"","pcpname":"PRIMARY HEALTH GROUP INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"N","ano":"","add2":"","add3":"","madd1":"1800 BELLOWS DR","madd2":"","madd3":"","mcity":"NORTH CHESTERFIELD","mstate":"VA","mzip":"23225-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F43.8","Z12.31","D50.9","I10","E78.2","E11.65","H35.033","R94.4","D50.8","E53.8","D69.6","F32.0","R94.5","Z68.26","M72.2","M21.6X2","M21.6X1","L60.9","E11.51","B07.0","B35.1","E55.9","E11.9","E78.5","K80.10","K80.20","Z23","K83.1","R04.0","L97.519","E11.3391","E11.3592","H43.811","L85.1","E11.42","Z00.01","R22.9","Z68.27","Z12.11","N18.2","E11.21"],"date":["2021-11-20","2021-05-15","2021-06-25","2022-03-22","2021-10-29","2021-12-07","2021-12-07","2021-12-07","2021-10-29","2021-10-29","2021-06-28","2021-07-22","2021-12-07","2021-12-07","2021-06-28","2021-06-28","2021-06-28","2021-07-15","2021-06-28","2021-06-28","2021-06-28","2022-03-22","2021-11-30","2020-08-06","2020-08-06","2020-08-06","2021-10-29","2021-11-05","2020-12-09","2021-11-19","2021-11-24","2021-11-24","2021-11-24","2021-11-30","2021-11-30","2020-12-22","2020-12-22","2020-12-22","2020-12-22","2022-03-22","2022-03-22"],"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":[["","00169643810","LEVEMIR","INJ FLEXTOUC","15.00","Select","Select",""],["","00093077198","PRAVASTATIN","TAB 10MG","90.00","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","100.00","Select","Select",""],["","68180051201","LISINOPRIL","TAB 2.5MG","90.00","Select","Select",""],["","00169750111","NOVOLOG","INJ 100\/ML","30.00","Select","Select",""],["","00093314505","CEPHALEXIN","CAP 250MG","40.00","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15.00","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0.50","Select","Select",""],["","33342002108","LEVOFLOXACIN","TAB 250MG","7.00","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":""}]}]}