{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"P ADNAMATTOPLIH","gend":1,"add":"      DR ESRUOC FLOG 0762                         ","city":"SPENCER                  ","state":"VA","zip":"24165-9998","dob":"1980-04-29","age":"","mstatus":"","insh":"10119477","cliId":"","pno":"9667234072","cno":"","email":"","ename":"","eno":"","pphy":"COLE, RICHARD C","ppno":2766944466,"pcpadd":"18877 JEB STUART HWY,","pcpcity":"Stuart","pcpstate":"VA","pcpzip":241715223,"pcpcounty":"","pcpid":"","pcpname":"PATRICK COUNTY FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"2670 GOLF COURSE RD                               ","madd2":"                                                  ","madd3":"","mcity":"SPENCER                  ","mstate":"VA","mzip":"24165-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","Z00.00","E55.9","K76.0","I10","Z00.01","F31.70","M54.5","J45.21","J06.9","F33.2","R06.02","Z88.0","Z88.1","Z88.8","F33.9","F60.3","F10.10","Z91.19","Z98.890","M99.03","S13.101A","S23.101A","S33.101A","S33.2XXA","S33.39XA","I87.2","L03.116","L03.115","L30.9","Z20.822","F41.1","F32.9","R44.2","R44.3","Z04.6","F29","Z86.59","R45.851","F25.9","F43.21","Z79.899","Z98.51","Z59.00","R41.82","F31.81","T50.902A","T43.292A","F17.210","F25.1","F10.20","E78.5","E78.00","Z91.14","Z63.8","Z59.01","F32.1","Y90.2","Z91.51"," ","F31.89","Z00.8","R94.31","F31.4","F31.30","F31.32","F31.9"],"date":["2022-10-11","2021-05-27","2021-05-27","2021-05-27","2021-08-15","2021-05-27","2021-05-27","2021-05-27","2021-08-10","2021-08-10","2022-06-10","2021-08-10","2022-11-21","2022-11-21","2022-11-21","2021-08-15","2022-12-09","2022-08-21","2021-08-15","2021-08-15","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-08-13","2021-07-12","2021-07-12","2021-07-12","2021-07-27","2022-11-21","2022-10-11","2022-09-14","2021-12-28","2021-12-28","2021-12-28","2022-11-21","2021-12-28","2022-11-21","2022-05-30","2022-09-12","2022-09-12","2022-09-12","2022-05-30","2022-06-01","2022-09-16","2022-08-19","2022-08-19","2022-08-19","2022-09-12","2022-10-14","2022-09-12","2022-09-12","2022-09-12","2022-09-12","2022-09-12","2022-09-12","2022-08-21","2022-08-21","2022-12-09","2022-12-09","2022-11-22","2022-11-22","2022-12-06","2022-11-21","2022-11-23","2022-11-23"],"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":[["","00115180401","HYDROXYZ","CAP 50MG","30","Select","Select",""],["","68462022110","LITHIUM","CAP 300MG","90","Select","Select",""],["","60505327803","OLANZAPINE","TAB 20MG ODT","21.00","Select","Select",""],["","65862005290","SIMVASTATIN","TAB 20MG","11","Select","Select",""],["","50458056301","INVEGA","INJ 156MG\/ML","1.00","Select","Select",""],["","31722088290","ROSUVASTATIN","TAB 5MG","30","Select","Select",""],["","68180031909","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","47335071013","TOPIRAMATE","TAB 50MG","60","Select","Select",""],["","68180035309","SERTRALINE","TAB 100MG","30","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","57237023305","SMZ-TMP","TAB 800-160","20","Select","Select",""],["","33342032980","TRIAMCINOLON","CRE 0.001","80","Select","Select",""],["","61874013030","VRAYLAR","CAP 3MG","30","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","49483060201","IBUPROFEN","TAB 400MG","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":""}]}]}