{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RA L YDOCTUORTNEM","gend":0,"add":"LIART NIATNUOM DNOCES 371                         ","city":"HINTON                   ","state":"VA","zip":"22831-9998","dob":"1968-12-03","age":"","mstatus":"","insh":"20115020","cliId":"","pno":"3804574730","cno":"","email":"","ename":"","eno":"","pphy":"QUINN, STACY","ppno":5405647300,"pcpadd":"1661 S MAIN ST,","pcpcity":"Harrisonburg","pcpstate":"VA","pcpzip":228012728,"pcpcounty":"","pcpid":"","pcpname":"RMH MEDICAL GROUP LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"173 SECOND MOUNTAIN TRAIL                         ","madd2":"                                                  ","madd3":"","mcity":"HINTON                   ","mstate":"VA","mzip":"22831-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R91.8","R59.0","J98.4","T84.50XD","J90","M75.01","M75.02","M25.511","E11.65","M25.512","M19.011","M19.012","M85.80","Z98.1","G89.29","R64","M48.061","G25.81","F45.42","M62.50","M62.81","R26.9","Z79.899","Z51.5","Z79.891","M50.30","M50.321","M54.2","G62.9","B35.3","Z23","L01.00"," ","R25.2","F51.04","K21.9","I10"],"date":["2022-09-28","2022-09-28","2022-09-28","2022-08-16","2022-08-16","2022-12-02","2022-12-02","2022-09-21","2022-09-09","2022-09-21","2022-09-21","2022-09-21","2022-09-21","2022-09-21","2022-12-01","2022-10-06","2022-12-01","2022-12-01","2022-12-01","2022-10-06","2022-10-06","2022-12-01","2022-10-06","2022-12-01","2022-10-06","2022-12-01","2022-09-21","2022-09-21","2022-12-01","2022-11-01","2022-11-01","2022-11-01","2022-12-02","2022-12-01","2022-12-01","2022-12-01","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":[]},{"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":[["","69097081312","GABAPENTIN","CAP 100MG","120","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","180","Select","Select",""],["","70710122801","AMITRIPTYLIN","TAB 75MG","30","Select","Select",""],["","00093342210","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","81131038679","RELION","MIS 32GX4MM","50","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","10","Select","Select",""],["","70010000201","COLCHICINE","TAB 0.6MG","30","Select","Select",""],["","50228014605","HYDROCHLOROT","CAP 12.5MG","90","Select","Select",""],["","45802006435","TRIAMCINOLON","CRE 0.001","15","Select","Select",""],["","70700015010","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","60","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","300","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","65862024608","LEVETIRACETA","TAB 500MG","60","Select","Select",""],["","93101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00093505998","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","00003089321","ELIQUIS","TAB 2.5MG","180","Select","Select",""],["","59385002360","BELBUCA","MIS 300MCG","60","Select","Select",""],["","69238110002","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","90","Select","Select",""],["","16714004107","ALLOPURINOL","TAB 100MG","90","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":""}]}]}