{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"M YNAFFITSMAILLIW ","gend":1,"add":"       EVA NOTGNIHSAW 629                         ","city":"NORFOLK                  ","state":"VA","zip":"23504-9998","dob":"1979-10-20","age":"","mstatus":"","insh":"10118430","cliId":"","pno":"4975710329","cno":7574527900,"email":"","ename":"","eno":"","pphy":"MACK, ALEXANDRA SLEDD","ppno":7574465955,"pcpadd":"825 FAIRFAX AVE 1ST FLOOR SUITE 118,HOFHEIMER HALL","pcpcity":"Norfolk","pcpstate":"VA","pcpzip":235071914,"pcpcounty":"","pcpid":"","pcpname":"GHENT FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"926 WASHINGTON AVE                                ","madd2":"                                                  ","madd3":"","mcity":"NORFOLK                  ","mstate":"VA","mzip":"23504-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","R56.9","K59.00","F33.2","G40.909","F70","Z53.20","Z88.8","Z91.010","T14.90XA","Z74.3","I63.9","Z86.39","Z68.25","F10.10","Z12.31","Z79.899","Z91.018","S09.90XA","T51.0X1A","Y90.8","I46.8","J69.0","J96.02","J96.01","R57.9","E44.0","E87.4","J98.11","G40.109","F10.121","G93.49","E83.39","B00.1","K76.0","E87.2","J96.90","I46.9","F43.21","I34.0","I95.9","F10.239","T78.3XXA","R91.8","R07.9","F10.229","F19.94","G93.40","S19.9XXA","W19.XXXA","R41.82","S03.2XXA","R74.8","R41.0","S02.401A","D47.3","F79","R74.0","F10.231","T51.0X1D","G93.1","D50.9","Z86.74","Z82.49","Z83.3","R45.87","R45.1","Z79.4","E11.9","Z86.73","Z87.891","Z91.14","R55","F10.188","Z09","F91.9","G40.009","Z01.89","Z23","G47.00"," "],"date":["2022-05-23","2021-12-28","2021-12-28","2020-02-05","2021-06-11","2021-06-11","2020-02-18","2021-06-11","2021-06-11","2021-03-18","2021-06-11","2022-05-23","2021-12-28","2021-05-04","2022-05-23","2021-05-04","2021-06-11","2021-06-11","2021-06-11","2020-07-17","2020-07-03","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-07-03","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-07-22","2020-06-05","2020-06-03","2020-07-22","2020-06-16","2020-06-09","2020-06-10","2020-06-10","2020-06-10","2020-06-09","2020-06-09","2020-07-03","2020-07-03","2020-07-22","2021-06-12","2021-06-11","2021-06-11","2021-06-11","2020-06-12","2021-06-12","2021-06-12","2020-06-14","2020-07-03","2020-07-03","2020-07-01","2020-07-03","2020-07-22","2020-07-03","2020-07-03","2020-07-03","2020-07-03","2020-07-03","2020-07-03","2020-07-20","2020-07-20","2020-07-20","2020-07-20","2020-07-20","2022-09-20","2020-07-22","2020-12-16","2020-09-16","2022-09-20","2020-12-16","2021-12-28","2022-05-23","2022-09-20"],"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":[["","16714035701","LEVETIRACETA","TAB 1000MG","60","Select","Select",""],["","00603548221","PROPRANOLOL","TAB 10MG","135","Select","Select",""],["","29300039810","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","27241000550","RISPERIDONE","TAB 3MG","30","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0.30","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":""}]}]}