{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" NYLIRAMYCATS B","gend":1,"add":"    EVIRD EDISREVIR 73072                         ","city":"GRUNDY                   ","state":"VA","zip":"24614-9998","dob":"1942-07-12","age":"","mstatus":"","insh":"10119074","cliId":"","pno":"3967261195","cno":2763129144,"email":"","ename":"","eno":"","pphy":"CORTELLESI, THOMAS B","ppno":2769352677,"pcpadd":"1109 PLAZA DR,STE 101","pcpcity":"Grundy","pcpstate":"VA","pcpzip":246146780,"pcpcounty":"","pcpid":"","pcpname":"FAMILY CARE CENTER LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"27037 RIVERSIDE DRIVE                             ","madd2":"                                                  ","madd3":"","mcity":"GRUNDY                   ","mstate":"VA","mzip":"24614-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R20.0","J44.9","R06.02","U07.1","J18.1","E87.1","I10","J12.82","E87.2","R05","R53.1","E86.0","R74.02","E87.8","E55.9","E03.9","K21.9","Z90.49","E53.8","E78.5","Z79.899","R53.83","R73.01","M79.671","D23.71","Q82.8","L84","H90.3","H92.03","M26.609","L29.9","Z20.828","H90.5","Z20.822","M79.604","R60.9","L53.9","M79.661","M79.674","M79.675","R27.0","G60.3","H25.89","H25.12","H25.11","H25.13","H16.223","H43.313","H52.4","H52.11","H52.02","H52.223","R63.4","G30.0","H25.812","R51.9","Z96.1","J18.9","D72.829","D64.9","I11.0","I50.810","N39.0","L03.115","R22.43","L03.116","R06.89","R79.1","R60.0","Z86.16","Z87.01","J81.1","Z23","H52.222","L97.919"," ","A46","R21","R70.0","Z91.012","Z79.890","Z79.51","M79.89","M79.662","H59.032","H52.12","H52.01","L25.5","R26.9"],"date":["2022-01-04","2022-10-05","2022-11-02","2021-03-24","2021-03-22","2022-11-07","2022-11-02","2021-03-24","2022-09-03","2021-03-22","2021-03-22","2021-03-22","2021-03-22","2022-11-07","2022-10-01","2022-11-02","2022-11-02","2022-11-02","2022-05-10","2022-05-10","2022-11-02","2022-05-10","2022-05-10","2020-10-21","2020-10-21","2020-10-21","2020-10-21","2020-10-19","2020-10-19","2020-10-19","2020-10-19","2020-11-02","2020-12-17","2022-11-02","2021-12-27","2021-12-27","2021-12-27","2022-11-02","2022-02-01","2022-02-01","2022-08-11","2022-08-11","2022-08-02","2022-08-02","2022-07-07","2022-05-03","2022-11-21","2022-11-21","2022-11-21","2022-08-02","2022-08-02","2022-11-21","2022-08-12","2022-08-12","2022-08-02","2022-11-21","2022-11-21","2022-10-01","2022-09-09","2022-10-01","2022-10-01","2022-10-01","2022-10-01","2022-10-23","2022-09-03","2022-10-23","2022-09-03","2022-09-03","2022-11-03","2022-10-01","2022-11-02","2022-09-03","2022-10-05","2022-08-02","2022-10-01","2022-12-12","2022-11-07","2022-11-02","2022-11-07","2022-11-02","2022-11-02","2022-11-02","2022-11-02","2022-11-02","2022-11-21","2022-11-21","2022-11-21","2022-12-12","2022-09-09"],"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":[["","00487950125","ALBUTEROL","NEB 0.00083","300","Select","Select",""],["","69097012715","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00172572880","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","00378180010","LEVOTHYROXIN","TAB 25MCG","30","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","31722055190","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","13668010230","DONEPEZIL","TAB 5MG","30","Select","Select",""],["","67877022205","GABAPENTIN","CAP 100MG","90.00","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00078074303","ILEVRO","DRO 0.3% OP","3","Select","Select",""],["","61314063705","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","49502010202","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","51672130005","AMMONIUM","LOT 0.12","225","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","00054001829","PREDNISONE","TAB 20MG","10","Select","Select",""],["","53746027205","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","00065853302","CIPRODEX","SUS 0.3-0.1%","7.5","Select","Select",""],["","143314205","DOXYCYCL","CAP 100MG","20","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":""}]}]}