{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CATHY L JONES","gend":1,"add":"723 S. ROSEMONT RD","city":"VIRGINIA BEACH","state":"VA","zip":234529999,"dob":"1960-12-28","age":"","mstatus":"","insh":11003894,"cliId":"2VV3RT0AE18","pno":7573057443,"cno":7579657526,"email":"","ename":"","eno":"","pphy":"JUER, ROBERT","ppno":7573051797,"pcpadd":"828 Healthy Way Ste 220","pcpcity":"Virginia Beach","pcpstate":"VA","pcpzip":234627960,"pcpcounty":"","pcpid":"P0060053","pcpname":"BONSECOURS MEDICAL ASSOCIATES","plan":"VPHP - VIRGINIA PREMIER","program":"Medicare","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["R07.89","K21.9","Z68.38","I10","M54.9","R21","K74.60","E55.9","R00.2","M25.562","M17.5","Z12.31","G89.29","Z68.39","Z79.899","F31.81","E66.9","Z68.35","F17.200","M17.12","M25.512","M47.816","M99.73","Z68.37","D69.6","Z76.0","R09.89","M62.830","M25.561","Z68.41","M62.81","J98.9","B18.2","I21.4","F10.11","R94.31"],"date":["2019-01-29","2020-08-26","2020-07-20","2021-04-23","2019-02-11","2020-02-24","2021-04-23","2021-04-23","2021-04-23","2021-02-23","2021-04-23","2019-05-29","2021-01-19","2019-05-29","2020-07-20","2018-07-08","2020-07-20","2018-07-08","2020-07-20","2021-02-23","2019-07-10","2019-07-10","2019-07-10","2020-07-19","2018-07-11","2020-07-19","2020-08-26","2020-08-26","2021-01-19","2021-04-23","2021-02-23","2021-04-23","2021-04-23","2021-04-23","2021-04-23","2021-04-23"],"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":[["","591544210","PREDNISONE","TAB 10MG","","Select","Select",""],["","68180051802","LISINOP\/HCTZ","TAB 10-12.5","","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","","Select","Select",""],["","228277811","PROPRANOLOL","CAP 60MG ER","","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","","Select","Select",""],["","68382050010","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","","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":[[["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["No","Select","","","","","Select","",""]]]},{"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":""}]}]}