{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ADNILSEMLOH","gend":1,"add":"          DR LLEDRAW 1461                         ","city":"CEDAR BLUFF              ","state":"VA","zip":"24609-9998","dob":"1954-09-07","age":"","mstatus":"","insh":"20113340","cliId":"","pno":"7967238031","cno":2769633083,"email":"","ename":"","eno":"","pphy":"HARMAN, NICHOLAS","ppno":2768893700,"pcpadd":"4675 REDBUD HWY,","pcpcity":"Honaker","pcpstate":"VA","pcpzip":242608004,"pcpcounty":"","pcpid":"","pcpname":"C HEALTH PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1641 WARDELL RD                                   ","madd2":"                                                  ","madd3":"","mcity":"CEDAR BLUFF              ","mstate":"VA","mzip":"24609-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H90.3","J01.00","H02.831","H02.834","H04.123"," "],"date":["2022-10-20","2022-11-21","2022-11-10","2022-11-10","2022-11-10","2022-11-21"],"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":[["","68462011940","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","76204020025","ALBUTEROL","NEB 0.00083","300","Select","Select",""],["","68001017903","GLIMEPIRIDE","TAB 4MG","180","Select","Select",""],["","70010006310","METFORMIN","TAB 500MG","90","Select","Select",""],["","52817033050","CYCLOBENZAPR","TAB 5MG","90","Select","Select",""],["","66689000816","NYSTATIN","SUS 100000","200","Select","Select",""],["","72578010092","LEVOFLOXACIN","TAB 750MG","10","Select","Select",""],["","186037020","SYMBICORT","AER 160-4.5","10.2","Select","Select",""],["","67877025180","TRIAMCINOLON","CRE 0.001","80","Select","Select",""],["","65862016999","ATENOLOL","TAB 50MG","90","Select","Select",""],["","31722052001","HYDRALAZINE","TAB 25MG","270","Select","Select",""],["","69315011610","FUROSEMIDE","TAB 20MG","90","Select","Select",""],["","65862059805","TAMSULOSIN","CAP 0.4MG","90","Select","Select",""],["","72205000399","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","68001036103","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","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":["",""],"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":""}]}]}