{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"S NERAKPOHSIB ","gend":1,"add":"B .O .P311 XO","city":"SAXIS","state":"VA","zip":"23427-0113","dob":"1965-01-02","age":"","mstatus":"","insh":"10118380","cliId":"","pno":"2875746344","cno":"","email":"","ename":"","eno":"","pphy":"HOSHINO, DAVID K","ppno":"7578245676          ","pcpadd":"8034 Lankford Hwy, ","pcpcity":"Oak Hall","pcpstate":"VA","pcpzip":"234162148","pcpcounty":"","pcpid":"","pcpname":"ATLANTIC COMMUNITY HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"P. O. BOX 113","madd2":"","madd3":"","mcity":"SAXIS","mstate":"VA","mzip":"23427-0113","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N39.41","F32.9","G11.9","E78.00","I10","K21.9","J45.20","R51","G93.5","G35","Z23","Z00.00","F51.01"],"date":["2020-01-21","2021-10-13","2020-08-12","2021-10-13","2021-10-13","2021-10-13","2020-07-29","2020-08-12","2020-08-12","2021-03-26","2020-10-09","2021-10-13","2021-10-13"],"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":[["","45802008801","ALBUTEROL","AER HFA","17.00","Select","Select",""],["","68382080601","TRAZODONE","TAB 100MG","30.00","Select","Select",""],["","68645051054","HYDROCHLOROT","TAB 25MG","90.00","Select","Select",""],["","31722070290","LOSARTAN","TAB 100MG","90.00","Select","Select",""],["","16714068403","SIMVASTATIN","TAB 40MG","90.00","Select","Select",""],["","00591365930","DESVENLAFAX","TAB 50MG ER","90.00","Select","Select",""],["","65862014836","SUMATRIPTAN","TAB 100MG","9.00","Select","Select",""],["","65862078430","ESOMEPRA","CAP 40MG DR","180.00","Select","Select",""],["","16729013716","CLONAZEPAM","TAB 1MG","90.00","Select","Select",""],["","59310057922","PROAIR","AER ","8.50","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6.00","Select","Select",""],["","69315090401","LORAZEPAM","TAB 0.5MG","60.00","Select","Select",""],["","61314064610","NEO\/POLY\/HC","SOL 1% OTIC","10.00","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":["",""],"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":""}]}]}