{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" W YORSETAO","gend":0,"add":"OTSDOOW 4331 TPA NL KC","city":"WINCHESTER               ","state":"VA","zip":"22601-9998","dob":"1937-11-24","age":"","mstatus":"","insh":"10118519","cliId":"","pno":"3904575261","cno":"","email":"","ename":"","eno":"","pphy":"BIRTH, BRAD JONATHAN","ppno":5406782800,"pcpadd":"104 SELMA DR,","pcpcity":"Winchester","pcpstate":"VA","pcpzip":226013834,"pcpcounty":"","pcpid":"","pcpname":"SELMA MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"334 WOODSTOCK LN APT 1","madd2":"","madd3":"","mcity":"WINCHESTER               ","mstate":"VA","mzip":"22601-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R06.00","D50.9","F17.201","Z23","I72.8","C18.9","E03.9","E78.5","F32.4","R20.0","R41.82","Z74.3","M62.81","G62.9","F03.90","R53.1","R20.2","C61","C79.51","M54.9","Z20.822","I10","K21.9","M25.551","D64.9","F32.A","F41.9","M54.16"],"date":["2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-04-27","2022-04-14","2022-04-14","2022-04-27","2022-04-14","2022-04-27","2022-04-27","2022-04-27","2022-05-11","2022-08-29","2022-05-11","2022-04-27","2022-08-09","2022-08-09","2022-08-09","2022-08-10","2022-04-27","2022-04-27","2022-04-27","2022-07-02","2022-10-14","2022-10-14","2022-10-14","2022-08-29"],"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":[["","68462039710","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","68180047903","SIMVASTATIN","TAB 20MG","90","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","70954006020","PREDNISONE","TAB 20MG","10","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":""}]}]}