{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ASSENAVLLEWOH M","gend":1,"add":"       EVIRD WEIVGNOL A51                         ","city":"WYTHEVILLE               ","state":"VA","zip":"24382-4046","dob":"1974-03-05","age":"","mstatus":"","insh":"10119838","cliId":"","pno":"8367297149","cno":"","email":"","ename":"","eno":"","pphy":"MCCONNELL, JAMES J","ppno":2762288951,"pcpadd":"365 W RIDGE RD,  ","pcpcity":"Wytheville","pcpstate":"VA","pcpzip":243821008,"pcpcounty":"","pcpid":"","pcpname":"JAMES J MCCONNELL MD PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APT 15A                                           ","add3":"","madd1":"15A LONGVIEW DRIVE                                ","madd2":"APT 15A                                           ","madd3":"","mcity":"WYTHEVILLE               ","mstate":"VA","mzip":"24382-4046","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","K76.0","E78.5","D64.9","M51.37","F41.9","R10.9","M79.605","R22.42","D3A.090","E34.0","F41.0","J09.X2","K21.9","Z20.828","R22.43","M47.816","M54.50","R10.2","M54.9","Z79.899","R92.8","K44.9","M79.604","Z82.49","Z85.118","Z79.891","F17.210","Z08","Z85.110","Z90.2","F43.8"],"date":["2022-05-20","2022-03-05","2022-03-05","2022-03-05","2022-03-05","2022-03-04","2022-03-04","2022-01-05","2022-01-05","2022-05-31","2022-05-20","2021-07-09","2021-11-30","2022-05-20","2021-08-13","2022-01-03","2022-03-05","2022-03-05","2022-03-05","2022-05-20","2022-05-20","2021-10-06","2022-05-31","2022-01-03","2022-01-03","2022-01-03","2022-01-03","2022-01-03","2022-06-10","2022-06-10","2022-06-10","2022-05-20"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":[["","33342008845","RIZATRIPTAN","TAB 10MG","10","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","25","Select","Select",""],["","53489014305","SPIRONOLACT","TAB 25MG","270","Select","Select",""],["","45802006405","TRIAMCINOLON","CRE 0.001","454","Select","Select",""],["","27808003502","HYDROCO\/APAP","TAB 5-325MG","90","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","69238111701","BUSPIRONE","TAB 10MG","90","Select","Select",""],["","57237000830","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","64764017530","DEXILANT","CAP 60MG DR","30","Select","Select",""],["","60758088005","FLUOROMETHOL","SUS 0.1% OP","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}