{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SALGUODETIHW ","gend":0,"add":"        EVA TNOMRIAF 2589                         ","city":"MANASSAS                 ","state":"VA","zip":"20109-9998","dob":"1962-01-04","age":"","mstatus":"","insh":"10118762","cliId":"","pno":"6330757292","cno":"","email":"","ename":"","eno":"","pphy":"KIM, YOUNG K","ppno":7032577749,"pcpadd":"9303 FOREST POINT CIR,","pcpcity":"Manassas","pcpstate":"VA","pcpzip":201104700,"pcpcounty":"","pcpid":"","pcpname":"MANASSAS INTERNAL MEDICINE PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"N","ano":"","add2":"#212                                              ","add3":"","madd1":"9852 FAIRMONT AVE                                 ","madd2":"#212                                              ","madd3":"","mcity":"MANASSAS                 ","mstate":"VA","mzip":"20109-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","S60.420A","R00.0","W23.0XXA","J44.9","K64.9","F41.1","F03.90","Z87.891","I48.91","I10","E11.59","F25.9","G47.33","R06.83","G47.10","R68.2","G47.51","G47.52","F51.3","G47.61","S69.91XA","M79.644","E11.9","Z88.8","Z79.84","Z79.899","S00.03XD","S80.01XD","S50.01XD","S00.01XD","R94.31","I48.92","J43.9","H26.9","H40.9","N17.9","N28.1","E11.65","J98.4","R63.5","F09","Z51.5","T56.891A","Z01.810","G89.11","R07.89","W18.30XA","Y92.039","R68.89","S00.03XA","S80.01XA","S50.01XA","S00.01XA","R09.02","L03.115","E78.2","R42","Z12.11","I77.1","R60.0","I48.0","F20.9","F41.9","J90","E78.5","F17.200","Z79.01","Z91.14","Z82.49","J98.11","R94.6","Z51.81","M79.604","R07.81","W01.0XXA","I51.7","I87.2","H10.11","Z00.00","Z13.89","Z91.81","Z12.5","R05.9","M70.51","M17.10","H40.20X3","T14.8XXA","I49.9","S19.9XXA","S09.93XA","M54.2","R51.9","R64","R05","J44.1","J96.21","J18.9","F32.9","R06.03","R06.82","J93.83","Z71.89","J93.12","J93.9","J96.01","M25.561","Z48.03","R06.02","Z99.81","Z87.01","Z66","F32.A","Z79.51","R41.82","D48.5","Z20.822","J81.0"," ","J81.1","R07.9"],"date":["2022-11-23","2020-04-29","2020-04-29","2020-04-29","2022-10-25","2021-08-19","2021-10-05","2022-10-25","2022-04-19","2022-10-25","2022-09-23","2020-12-16","2022-10-25","2021-04-22","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2020-04-29","2020-04-29","2022-10-25","2020-12-15","2020-12-15","2021-11-16","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2022-03-18","2021-07-02","2022-04-19","2021-10-05","2022-04-21","2020-10-30","2020-10-30","2022-06-07","2022-02-11","2021-09-20","2022-06-06","2022-03-22","2020-10-30","2022-03-18","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-12-16","2021-07-02","2021-06-20","2021-06-20","2021-06-20","2022-03-19","2021-11-16","2022-06-07","2021-12-29","2021-11-16","2021-11-29","2022-07-14","2022-09-23","2020-12-15","2020-12-15","2020-12-16","2020-12-15","2020-12-15","2020-12-15","2020-12-15","2020-12-15","2022-04-02","2021-03-15","2021-03-15","2020-05-05","2020-11-13","2020-11-13","2021-07-02","2021-07-20","2021-09-20","2021-04-07","2021-04-07","2021-04-07","2021-04-07","2022-10-25","2021-10-31","2021-11-16","2022-02-09","2020-04-29","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-09-15","2021-09-16","2022-10-25","2022-06-09","2022-10-25","2022-06-09","2022-03-18","2022-03-19","2022-04-21","2022-03-23","2022-04-19","2022-04-20","2022-03-22","2021-12-07","2022-04-20","2022-10-25","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-04-19","2022-06-07","2022-08-03","2022-10-25","2022-10-25","2022-11-23","2022-10-25","2022-10-25"],"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":[["","16729020016","BUSPIRONE","TAB 5MG","30.00","Select","Select",""],["","59148001971","ABILIFY","INJ 400MG","1","Select","Select",""],["","31722052010","HYDRALAZINE","TAB 25MG","90","Select","Select",""],["","69315013610","BENZTROPINE","TAB 0.5MG","60","Select","Select",""],["","67877056110","METFORMIN","TAB 500MG","60","Select","Select",""],["","51991029405","OXCARBAZEPIN","TAB 600MG","60","Select","Select",""],["","43547028111","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","55111046705","METOPROL","TAB 50MG ER","30","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","60505258008","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","43547035311","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","60505015701","BUPROPION","TAB 100MG","30","Select","Select",""],["","27241005408","ARIPIPRAZOLE","TAB 15MG","30","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","45802011222","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","23155005101","NYSTATIN","TAB 500000","120","Select","Select",""],["","68462053047","CLOBETASOL","OIN 0.0005","45","Select","Select",""],["","80777027310","MODERNA","INJ COVID-19","0.25","Select","Select",""],["","42571016242","AMOX\/K","TAB 875-125","30","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","16","Select","Select",""],["","65162044210","MECLIZINE","TAB 25MG","60","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","14","Select","Select",""],["","45802046653","ECONAZOLE","CRE 0.01","85","Select","Select",""],["","45963067611","METOPROLOL","TAB 50MG ER","90","Select","Select",""],["","49281042050","FLUZONE","INJ 2020-21","0.5","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":""}]}]}