{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"YHTORODETAT M ","gend":1,"add":" LLUB 094DAOR KCEN","city":"HAGUE","state":"VA","zip":"22469-9998","dob":"1932-08-04","age":"","mstatus":"","insh":"10116975","cliId":"","pno":"3240843928","cno":8044722934,"email":"","ename":"","eno":"","pphy":"AMBROS, DONNA L","ppno":8045296141,"pcpadd":"856 J Clyde Morris Blvd Ste A, ","pcpcity":"Newport News","pcpstate":"VA","pcpzip":236011318,"pcpcounty":"","pcpid":"","pcpname":"VCU HEALTH MCV PHYSICIANS PRIMARY CARE AT CALLAO","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"490 BULL NECK ROAD","madd2":"","madd3":"","mcity":"HAGUE","mstate":"VA","mzip":"22469-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R69","F03.90","E46","E11.22","I10","R00.2","E78.5","Z86.718","R39.81","M62.81","E53.8","R53.83","R73.9","I12.9","N18.30","R30.0","E66.01","Z23","Z68.35","K80.20","R07.9","R10.13","R07.89","K58.9","Z87.19","E66.9","Z79.1","Z79.899","R10.0","R10.11","K59.00","R94.31","R11.0","K57.30","K56.41","R06.89","R91.8","I70.0","F02.81","F41.9","R09.89","J98.6","M85.80","M47.814","M41.85","F22","F03.91","N39.0","N30.00","Z79.84","F02.80","R60.9","K21.9","F41.1","E11.9","F29","N18.31","H40.10X2","R42","I49.3","I49.5","I51.7"],"date":["2022-03-28","2022-03-31","2022-03-10","2022-04-04","2022-04-06","2021-01-13","2022-04-05","2021-01-13","2022-03-16","2022-04-06","2021-10-21","2021-05-07","2021-05-25","2022-04-04","2022-04-04","2021-06-15","2021-10-21","2021-10-21","2021-10-21","2022-03-16","2022-03-29","2020-12-15","2022-03-29","2020-12-15","2020-12-15","2020-12-15","2020-12-15","2022-04-04","2020-12-15","2020-12-15","2022-03-16","2022-04-01","2022-03-16","2022-03-16","2022-03-16","2022-03-16","2022-03-31","2022-03-31","2022-04-05","2022-04-04","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-04-11","2022-04-06","2022-04-05","2022-04-06","2022-04-03","2022-04-05","2022-04-05","2022-04-05","2022-04-05","2022-04-05","2022-04-05","2022-04-05","2022-04-05","2022-03-31","2022-03-29","2022-03-29","2022-04-01"],"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":[["","60505006501","OMEPRAZOLE","CAP 20MG","180","Select","Select",""],["","68382032001","POT  CHLORIDE","TAB 10MEQ ER","90","Select","Select",""],["","55111032001","GLIMEPIRIDE","TAB 1MG","60","Select","Select",""],["","65162078503","MEMANTINE","CAP 28MG ER","90","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","100","Select","Select",""],["","43547027509","DONEPEZIL","TAB 5MG","90","Select","Select",""],["","43547033950","RISPERIDONE","TAB 0.25MG","180","Select","Select",""],["","16729036715","OLM","TAB 40-12.5","45","Select","Select",""],["","00378395005","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","42799012001","BUMETANIDE","TAB 1MG","180","Select","Select",""],["","31722077701","ACYCLOVIR","TAB 400MG","90","Select","Select",""],["","61314054701","LATANOPROST","SOL 0.00005","7.5","Select","Select",""],["","49281012065","FLUZONE","INJ PF 20-21","0.7","Select","Select",""],["","16729021716","SERTRALINE","TAB 100MG","90","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","10.00","Select","Select",""],["","72606050902","FAMOTIDINE","TAB 20MG","30.00","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":""}]}]}