{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"C AYNATYREVA ","gend":1,"add":"ER 2123RD ESE","city":"PORTSMOUTH               ","state":"VA","zip":"23703-9998","dob":"1967-11-03","age":"","mstatus":"","insh":"10118848","cliId":"","pno":"3375797339","cno":"","email":"","ename":"","eno":"","pphy":"MCHUGH, JASON M","ppno":7576865673,"pcpadd":"3253 TAYLOR RD STE 200,STE 300","pcpcity":"Chesapeake","pcpstate":"VA","pcpzip":233212452,"pcpcounty":"","pcpid":"","pcpname":"WESTERN BRANCH FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"3212 REESE DR","madd2":"                                                  ","madd3":"","mcity":"PORTSMOUTH               ","mstate":"VA","mzip":"23703-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z79.01","D57.1","R94.31","R55","I63.50","R01.1","I35.8","I27.89","I34.8","R06.89","R00.2","Z86.718","R79.89","D50.8","E55.9","D64.9","E83.111","D68.9","D57.00","D51.3","E78.5","Z13.39","I63.9","Z68.1","I82.509","E83.19","Z00.00","H35.362","H25.12","H40.53X2","H18.421","H40.031","H33.21"],"date":["2022-09-25","2022-07-28","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2022-09-01","2021-09-26","2022-08-30","2022-08-30","2022-08-30","2022-05-11","2022-05-11","2022-08-30","2022-08-30","2022-05-11","2022-08-30","2022-05-25","2022-05-25","2022-08-30","2021-12-14","2022-05-11","2022-05-25","2022-09-27","2022-09-27","2022-09-27","2022-03-01","2021-08-31","2022-09-27"],"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":[["","00078065615","JADENU","TAB 360MG","60","Select","Select",""],["","61314063136","NEO\/POLY\/DEX","OIN 0.1% OP","7","Select","Select",""],["","70069005101","DORZOL\/TIMOL","SOL 22.3-6.8","10","Select","Select",""],["","51672403201","WARFARIN","TAB 5MG","60","Select","Select",""],["","00591207030","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","72495020210","FEMRING","MIS 0.1MG\/24","1","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":""}]}]}