{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" M NOSAJNOTSRUHT","gend":0,"add":"VIL LAITNEDISER EDISSLLIH                      GNI","city":"STAUNTON                 ","state":"VA","zip":"24401-3464","dob":"1982-05-04","age":"","mstatus":"","insh":"10119052","cliId":"","pno":"6804558360","cno":5408606385,"email":"","ename":"","eno":"","pphy":"TURNER, STEPHEN D","ppno":5402457425,"pcpadd":"43 PINNACLE DR,","pcpcity":"FISHERSVILLE","pcpstate":"VA","pcpzip":22939,"pcpcounty":"","pcpid":"","pcpname":"AUGUSTA MEDICAL GROUP","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"403  N COALTER STREET                             ","add3":"","madd1":"HILLSSIDE RESIDENTIAL LIVING                      ","madd2":"403  N COALTER STREET                             ","madd3":"","mcity":"STAUNTON                 ","mstate":"VA","mzip":"24401-3464","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.1","F79","G40.109","G40.802","G40.909","R56.9","R40.0","I48.91","I10","Z72.0","Z79.899","G40.409","Z86.69","Z87.891","T74.01XA","Y07.499","E87.5","I12.0","N18.6","Z99.2","E11.22","Z79.4","E10.65","E78.2","F41.9","F29","Z60.8","Z91.128","R46.2","F22","X58.XXXA","E72.20","Z91.411","Z56.0","Z59.0","Z81.8","E72.29","R44.3","F17.210","E10.69","M86.9","D62","L02.416","M87.9","Z16.19","E10.43","E10.621","Z20.822","B96.5","E10.22","N25.81","L89.629","D63.1","Z02.89","L89.624","I70.243","M86.172","M86.672","M87.875","M86.8X7","Z11.59","Z20.828","L97.522","L97.509","L97.424","E10.9","L03.90","F20.9","L89.623","Z48.00","L97.508","E08.621","L97.429","L97.529","E10.40","Z65.8","Z59.9","E10.10","L97.511","L97.428","D63.8","R78.81","A41.9","L08.9","Z68.21","R73.9","E13.10","L97.423","M86.472","Z68.22","D64.9","L97.518","L97.414","S62.514A","S62.201A","W06.XXXA","M79.644","S69.91XA","W19.XXXA","Y71.2","E43","T82.510A","Z68.1","E10.42","Z51.81","E55.9","F19.10"," "],"date":["2022-12-01","2022-10-26","2022-01-21","2022-01-21","2022-10-07","2021-08-22","2021-03-02","2021-03-02","2021-09-22","2021-03-02","2022-10-26","2021-08-22","2021-08-22","2021-09-30","2020-08-16","2020-06-26","2021-09-23","2021-10-27","2021-10-29","2021-10-29","2021-07-03","2021-07-03","2021-10-29","2021-07-21","2022-10-07","2021-08-22","2020-08-04","2020-08-05","2020-08-05","2020-10-01","2020-08-16","2020-08-18","2020-08-16","2020-08-16","2020-08-16","2020-08-16","2020-08-18","2020-08-29","2021-08-22","2021-10-29","2021-10-29","2021-09-12","2021-09-12","2021-08-24","2021-08-24","2021-10-22","2021-10-29","2021-08-24","2021-08-24","2021-10-29","2021-10-22","2021-08-24","2021-10-29","2020-08-25","2021-08-25","2021-09-23","2021-10-18","2021-10-25","2021-08-31","2021-08-31","2020-08-29","2020-08-29","2021-08-30","2021-09-17","2021-10-27","2021-09-22","2020-09-22","2022-07-29","2021-10-06","2021-09-27","2021-09-27","2021-10-23","2021-10-29","2021-09-30","2021-09-30","2020-10-01","2020-10-01","2021-10-18","2021-10-25","2021-10-27","2021-10-22","2021-10-27","2021-10-22","2021-10-18","2021-10-25","2021-10-23","2021-10-23","2021-10-25","2021-10-25","2021-10-27","2021-10-25","2021-10-29","2021-10-27","2022-08-02","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2022-06-16","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2021-10-22","2022-10-26","2022-08-19","2022-10-07","2022-12-01"],"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","168","Select","Select",""],["","69097086107","ZONISAMIDE","CAP 100MG","450","Select","Select",""],["","62756079813","DIVALPROEX","TAB 500MG DR","112","Select","Select",""],["","27241000150","RISPERIDONE","TAB 1MG","28","Select","Select",""],["","23155050201","HYDROXYZ","TAB 50MG","28","Select","Select",""],["","42799080601","IVERMECTIN","TAB 3MG","7","Select","Select",""],["","69238110002","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","67877031905","IBUPROFEN","TAB 400MG","30","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}