{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"A   NELEHTTOILLE ","gend":1,"add":"IV DLO 7104DAOR AINIGR","city":"CHESAPEAKE","state":"VA","zip":"23323-9998","dob":"1941-08-15","age":"","mstatus":"","insh":"24000910*816","cliId":"","pno":"84\/7570490-8","cno":"","email":"","ename":"","eno":"","pphy":"HAYES, ANTHONY J MD","ppno":"757\/967-9203","pcpadd":"2011 QUEEN STREET SUITE L100","pcpcity":"PORTSMOUTH","pcpstate":"VA","pcpzip":23704,"pcpcounty":"","pcpid":"","pcpname":"CONTINENTAL MEDICAL CENTER","plan":"OHP","program":"MEDICARE","lob":"MA-Non DSNP","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I25.10","I11.0","E78.00","I50.32","R00.2","Z12.31","E78.5","I10.","R53.83","G50.0","I20.8","G60.3","H40.023","H25.013","H25.13","I50.31"],"date":["2021-06-07","2021-06-07","2021-06-07","2021-06-07","2021-06-13","2022-09-01","2021-03-10","2022-04-07","2021-06-16","2022-11-02","2021-06-01","2022-11-02","2021-10-21","2021-10-21","2021-10-21","2021-06-01"],"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":{"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":[["","57664047758","METOPROL","TAB 50MG","180","Select","Select",""],["","67877019790","AMLODIPINE","TAB 2.5MG","30","Select","Select",""],["","59762330403","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","69097067805","PREGABALIN","CAP 50MG","90","Select","Select",""],["","65162010110","GABAPENTIN","CAP 100MG","60","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","68462013901","OXCARBAZEPIN","TAB 600MG","60","Select","Select",""],["","63304082805","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","69452029020","ACYCLOVIR","TAB 400MG","35","Select","Select",""],["","62756024064","ONDANSETRON","TAB 4MG ODT","14","Select","Select",""],["","33342002607","FAMCICLOVIR","TAB 500MG","21","Select","Select",""],["","65162062710","TRAMADOL","TAB 50MG","28","Select","Select",""],["","59762444002","METHYLPRED","TAB 4MG","21","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":""}]}]}