{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" NERAKWAHS L","gend":1,"add":"NIARROL 5979YAW LORAC E","city":"LORTON                   ","state":"VA","zip":"22079-2135","dob":"1978-04-10","age":"","mstatus":"","insh":"10117177","cliId":"","pno":"4630703146","cno":"","email":"","ename":"","eno":"","pphy":"BAUER, CHRISTINIA A","ppno":7034946111,"pcpadd":"12480 DILLINGHAM SQ,","pcpcity":"Woodbridge","pcpstate":"VA","pcpzip":221925258,"pcpcounty":"","pcpid":"","pcpname":"INOVA MEDICAL GROUP LAKERIDGE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"9795 LORRAINE CAROL WAY","madd2":"                                                  ","madd3":"","mcity":"LORTON                   ","mstate":"VA","mzip":"22079-2135","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H61.23","U07.1","J06.9","Z91.81","M25.673","F71","F63.9","F20.0","M62.838","R29.898","F79","M51.27","M47.816","M47.26","M48.062","M25.372","Z03.818","Z11.59","B35.3","M17.12","M17.11","R29.6","M79.601","M25.562","M79.602","M17.0","Z98.51","Z87.891","S59.902A","S59.901A","S89.92XA","S89.91XA","S69.92XA","S69.91XA","Z79.899","M25.561","R35.0","W19.XXXD","Z23","Z00.00","E55.9","Z11.1","Z12.31","J30.2","J31.0","Z59.3","K59.09","E66.9","Z68.36","M21.172","M19.072","M10.00","S93.412A","M25.572","R60.9","M1A.0720","S93.601A","R32","I87.2","S20.212A","Z04.1","M54.50","V89.2XXD","S20.212D","M76.812","S92.902A","Z03.89","E87.6","E87.1","S92.315A","S92.325A","S92.345A","S92.314A","S92.514A","R22.43","S79.922A","S79.921A","S92.312A","S92.322A","Z20.822","S92.511A","S92.342A","M79.671","M79.662","R53.1"],"date":["2022-01-14","2022-01-18","2022-01-18","2022-09-16","2021-04-09","2022-08-26","2022-08-26","2022-08-26","2021-04-28","2021-03-31","2022-09-16","2021-04-28","2021-04-28","2021-04-28","2021-04-28","2021-05-10","2020-06-25","2020-06-25","2021-10-01","2021-07-24","2021-07-24","2021-07-24","2021-07-24","2021-08-06","2021-07-24","2021-07-24","2021-07-24","2021-07-24","2021-07-24","2021-07-24","2021-07-24","2022-09-16","2021-07-24","2021-07-24","2022-09-13","2022-08-19","2021-08-06","2021-08-06","2021-09-30","2021-10-22","2022-05-02","2021-10-22","2021-10-22","2022-05-02","2022-05-02","2022-05-02","2022-05-02","2021-12-20","2022-05-02","2021-12-22","2021-12-22","2021-12-23","2021-12-23","2021-12-23","2022-05-16","2021-12-23","2022-03-15","2022-05-02","2022-05-16","2022-06-14","2022-06-24","2022-08-01","2022-08-01","2022-06-16","2022-05-16","2022-09-16","2022-09-13","2022-09-14","2022-09-14","2022-09-17","2022-09-17","2022-09-17","2022-09-17","2022-09-17","2022-09-16","2022-09-16","2022-09-16","2022-09-16","2022-09-16","2022-09-13","2022-09-16","2022-09-16","2022-09-16","2022-09-16","2022-09-13"],"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":[["","52817031910","BACLOFEN","TAB 5MG","90","Select","Select",""],["","68462015305","TOPIRAMATE","TAB 50MG","62","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","68462013901","OXCARBAZEPIN","TAB 600MG","40.5","Select","Select",""],["","43547034450","RISPERIDONE","TAB 4MG","40.5","Select","Select",""],["","13668044201","CELECOXIB","CAP 200MG","30","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","00168009930","KETOCONAZOLE","CRE 0.02","120","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","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":["",""]}},{"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":""}]}]}