{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"W HAROBEDSELPATS ","gend":1,"add":"TNUOM HTIMS 1353YAWHGIH EKAL NIA","city":"HUDDLESTON","state":"VA","zip":"24104-3718","dob":"1955-11-19","age":"","mstatus":"","insh":"10116495","cliId":"","pno":"2243489991","cno":8593121924,"email":"","ename":"","eno":"","pphy":"STIRGWOLT, JENNIFER K","ppno":8042766900,"pcpadd":"10130 HULL STREET RD,","pcpcity":"Midlothian","pcpstate":"VA","pcpzip":231123300,"pcpcounty":"","pcpid":"","pcpname":"PRIMARY HEALTH GROUP INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"LOT 16","add3":"","madd1":"3531 SMITH MOUNTAIN LAKE HIGHWAY","madd2":"LOT 16","madd3":"","mcity":"HUDDLESTON","mstate":"VA","mzip":"24104-3718","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R05","J44.9","S72.141A","M16.11","S72.001A","Z71.6","R52","R09.02","M25.551","M25.572","W19.XXXA","Z23","M54.5","K21.9","S72.144A","E87.1","S62.511A","I10","F17.210","D50.9","M80.051A","Z72.0","Z91.89","W01.0XXA","S72.101A","Z76.89","F41.9","R05.9","Z13.220","Z13.228","R53.83","Z11.4","Z11.59","G47.00","J30.2","M51.36","M43.16"],"date":["2021-01-05","2021-05-21","2021-06-10","2021-05-21","2021-06-04","2021-06-04","2021-05-21","2021-05-21","2021-05-21","2021-05-21","2021-05-21","2021-11-22","2021-02-01","2022-08-19","2021-05-21","2021-05-21","2021-05-21","2022-08-19","2021-05-21","2021-05-21","2021-06-10","2020-12-18","2020-12-18","2021-05-21","2021-05-22","2021-11-22","2021-11-28","2022-08-19","2021-11-22","2021-11-22","2021-11-22","2021-11-22","2021-11-22","2022-08-19","2021-12-21","2021-02-01","2021-02-01"],"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":[["","50111056001","TRAZODONE","TAB 50MG","60","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","50742062001","NIFEDIPINE","TAB 30MG ER","30","Select","Select",""],["","57664050183","MIRTAZAPINE","TAB 45MG","90","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","60","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","68382003516","VENLAFAXINE","CAP 75MG ER","30","Select","Select",""],["","13668000705","ZOLPIDEM","TAB 5MG","30","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","15","Select","Select",""],["","00955100410","ENOXAPARIN","INJ 40\/0.4ML","12","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":""}]}]}