{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"IVAN L STEWART","gend":0,"add":"1442 TREEHAVEN DRIVE ","city":"RICHMOND ","state":"VA","zip":"23224-9998","dob":"1957-01-07","age":"","mstatus":"","insh":11000867,"cliId":"3J06GC1RX56","pno":8043091327,"cno":8043091327,"email":"","ename":"","eno":"","pphy":"BONNER, LLOYD ARDEN  ","ppno":8043258801,"pcpadd":"505 W Leigh St,Ste 205","pcpcity":"Richmond ","pcpstate":"VA","pcpzip":232203239,"pcpcounty":"","pcpid":"P0119141","pcpname":"PRIMARY HEALTH CARE ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1442 TREEHAVEN DRIVE ","madd2":"","madd3":"","mcity":"RICHMOND ","mstate":"VA","mzip":"23224-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","M25.551","G89.29","K59.09","R79.9","Z09","E53.8","R53.1","R63.4","E55.9","R35.1","Z79.899","H93.299","I11.9","R94.31","H53.8","M16.0","M25.511","Z91.09","K59.00","E11.9","E11.69","Z68.25","E78.2","Z92.29","R06.02","R79.89","M25.751","M47.817","G89.4","M15.9","H61.21","M54.31","M25.541","Z71.2","F17.210","Z12.11"],"date":["2020-02-18","2021-09-21","2020-05-12","2019-01-03","2020-02-18","2019-01-03","2021-09-21","2020-02-18","2020-02-18","2021-09-21","2020-02-18","2020-02-18","2020-02-18","2020-02-18","2020-02-18","2019-01-03","2019-02-27","2018-01-16","2021-09-21","2018-03-22","2021-09-21","2020-05-12","2021-03-29","2021-09-21","2020-02-18","2020-02-18","2020-02-18","2019-02-27","2019-02-27","2018-04-18","2021-09-21","2018-04-18","2021-03-10","2021-03-10","2021-03-29","2021-09-21","2021-09-21"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","65162062711","TRAMADOL HCL","TAB 50MG","","Select","Select",""],["","597015330","JARDIANCE","TAB 25MG","","Select","Select",""],["","71101368","LYRICA","CAP 50MG","","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","","Select","Select",""],["","193731221","CONTOUR","TES NEXT","","Select","Select",""],["","193658621","MICROLET","MIS LANCETS","","Select","Select",""],["","64764024060","AMITIZA","CAP 24MCG","","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","","Select","Select",""],["","65702040810","ACCU-CHEK","TES AVIVA PL","","Select","Select",""],["","55111012105","ATORVASTATIN","TAB 10MG","","Select","Select",""],["","143301801","COLCHICINE","CAP 0.6MG","","Select","Select",""],["","193654621","BAYER MICRLT","MIS LANCETS","","Select","Select",""],["","65862001705","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","","Select","Select",""],["","65162003311","APAP\/CODEINE","TAB 300-30MG","","Select","Select",""],["","23155010205","METFORMIN","TAB 500MG","","Select","Select",""],["","65702040810","ACCU-CHEK ","TES AVIVA PL","300","Select","Select",""],["","16571020150","DICLOFENAC ","TAB 75MG DR","60","Select","Select",""],["","597015330","JARDIANCE ","TAB 25MG","90","Select","Select",""],["","65162062711","TRAMADOL ","TAB 50MG","60","Select","Select",""],["","71101368","LYRICA ","CAP 50MG","60","Select","Select",""],["","193731221","CONTOUR ","TES NEXT","300","Select","Select",""],["","29300012510","MELOXICAM ","TAB 15MG","30","Select","Select",""],["","193658621","MICROLET ","MIS LANCETS","100","Select","Select",""],["","64764024060","AMITIZA ","CAP 24MCG","10","Select","Select",""],["","378718505","METFORMIN ","TAB 500MG","240","Select","Select",""],["","55111012105","ATORVASTATIN ","TAB 10MG","30","Select","Select",""],["","143301801","COLCHICINE ","CAP 0.6MG","10","Select","Select",""],["","65862001705","AMOXICILLIN ","CAP 500MG","28","Select","Select",""],["","64380080707","IBUPROFEN ","TAB 800MG","20","Select","Select",""],["","193654621","BAYER ","MIS LANCETS","100","Select","Select",""],["","65162003311","APAP\/CODEINE ","300-30MG","60","Select","Select",""],["","65162062711","TRAMADOL","50MG","60","Select","Select",""],["","00193654621","BAYER","LANCETS","100","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","300","Select","Select",""],["","99073070914","FREESTYLE    KIT FREEDOM","KIT FREEDOM","1","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["Yes","Select","",false,""],["Yes","Select","",false,""],["Yes","Select","",false,""],["Yes","Select","",false,""],["No","Select","",false,""],["Yes","Select","",false,""],["N\/A","Select","",false,""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}