{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"M AIKAZHTIMS ","gend":1,"add":"            DR DNALEEL 28                         ","city":"FREDERICKSBURG           ","state":"VA","zip":"22405-9998","dob":"1981-01-21","age":"","mstatus":"","insh":"10118192","cliId":"","pno":"9804503449","cno":"","email":"","ename":"","eno":"","pphy":"PASCOE, CARRIE L","ppno":8046335840,"pcpadd":"121 COURTHOUSE LN,","pcpcity":"Bowling Green","pcpstate":"VA","pcpzip":224279336,"pcpcounty":"","pcpid":"","pcpname":"MARY WASHINGTON HEALTHCARE PHYSICIANS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"82 LEELAND RD                                     ","madd2":"                                                  ","madd3":"","mcity":"FREDERICKSBURG           ","mstate":"VA","mzip":"22405-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N91.2","N39.498","R39.81","L22","F79","F63.9","F41.1","F78","G40.909","B35.3","L85.3","G40.911","L84","G40.319","G40.219","R26.0","R56.9","N30.90","J98.11","F80.89","R62.50","F88","R10.9","M25.50","Z00.00","L60.3","G40.001","M13.80","M25.511","I10","I63.9","E11.59","E78.5","F17.200","Z01.818","M79.2","M48.061","R06.83","R40.0","Z79.4","T23.261D","E11.9"," ","L89.152","M19.90","R53.1","Z79.899","M47.26","Z23","L98.9","Z51.89"],"date":["2022-10-18","2022-10-28","2022-10-28","2022-10-28","2022-10-28","2022-10-11","2021-03-30","2021-03-30","2022-11-22","2022-09-06","2022-09-06","2022-09-06","2022-09-06","2020-10-30","2022-03-01","2022-09-01","2022-09-01","2021-09-28","2021-09-28","2021-09-28","2021-09-28","2021-09-28","2021-09-28","2021-10-05","2021-10-05","2022-09-06","2022-03-21","2022-03-21","2022-04-19","2022-11-14","2022-11-14","2022-08-23","2022-11-14","2022-08-23","2022-08-23","2022-08-23","2022-11-14","2022-08-23","2022-08-23","2022-11-14","2022-10-14","2022-11-14","2022-11-22","2022-11-22","2022-11-22","2022-11-14","2022-11-14","2022-11-14","2022-11-10","2022-11-10","2022-11-08"],"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":[["","00131541072","VIMPAT","SOL 10MG\/ML","900","Select","Select",""],["","57237001930","DULOXETINE","CAP 60MG","28","Select","Select",""],["","51672127302","FLUOCINONIDE","SOL 0.0005","20","Select","Select",""],["","51672406901","PHENYTOIN","SUS 125\/5ML","237","Select","Select",""],["","67877073295","LACOSAMIDE","SOL 10MG\/ML","1,200.00","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","70461032003","FLUCLVX","INJ 2020-21","0.5","Select","Select",""],["","68180044101","CEPHALEXIN","SUS 250\/5ML","300","Select","Select",""],["","47781030801","NITROFUR","CAP 100MG","10","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":""}]}]}