{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STEVEN K BEARD","gend":0,"add":"520 WALNUT ST  ","city":"PETERSBURG  ","state":"VA","zip":"23803-9998","dob":"1990-08-19","age":"","mstatus":"","insh":11008047,"cliId":"2JY7Y56EY56","pno":8042143841,"cno":8042143841,"email":"","ename":"","eno":"","pphy":"QUARSHIE, GEORGE  ","ppno":8045263500,"pcpadd":"20901 Chesterfield Ave","pcpcity":"Petersburg  ","pcpstate":"VA","pcpzip":238031903,"pcpcounty":"","pcpid":"P0125636","pcpname":"SOUTHSIDE PHYSICIAN NETWORK LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"520 WALNUT ST  ","madd2":"","madd3":"","mcity":"PETERSBURG  ","mstate":"VA","mzip":"23803-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F33.1","F25.1","R73.9","T30.0","E66.3","R63.8","M79.675","R45.89","F34.81","F42.9","T50.905D","E66.01","Z68.36","L90.5","R53.83","F20.9"],"date":["2021-11-01","2021-10-22","2020-01-22","2020-01-22","2021-03-23","2020-01-22","2020-03-18","2020-05-13","2020-05-13","2020-07-01","2020-07-21","2020-07-21","2021-09-23","2019-10-28","2021-09-23","2021-11-01"],"priorHcc":[null,null,"","","","","","","","","","","","","",null]}},{"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":[["","65862066330","ARIPIPRAZOLE","TAB 10MG","","Select","Select",""],["","65862019301","FLUOXETINE","CAP 20MG","","Select","Select",""],["","60505265401","TRAZODONE","TAB 100MG","","Select","Select",""],["","43547034350","RISPERIDONE","TAB 3MG","","Select","Select",""],["","45963014205","BUPROPN HCL","TAB 300MG XL","","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","","Select","Select",""],["","45802005535","TRIAMCINOLON","OIN 0.001","","Select","Select",""],["","43547034350","RISPERIDONE ","TAB 3MG","30","Select","Select",""],["","50111064801","FLUOXETINE ","CAP 20MG","60","Select","Select",""],["","60505265401","TRAZODONE ","TAB 100MG","30","Select","Select",""],["","65862066330","ARIPIPRAZOLE ","TAB 10MG","30","Select","Select",""],["","68180032002","BUPROPN ","TAB 300MG XL","30","Select","Select",""],["","45802005535","TRIAMCINOLON ","OIN 0.001","15","Select","Select",""],["","64380080807","IBUPROFEN ","TAB 600MG","30","Select","Select",""],["","68180032002","BUPROPN","300MG XL","30","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":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","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":""}]}]}