{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRYAN W BOYCE","gend":0,"add":"3137 BRUNO DR  ","city":"CHESAPEAKE  ","state":"VA","zip":"23323-9998","dob":"1998-12-17","age":"","mstatus":"","insh":11009407,"cliId":"2KK1T58NM96","pno":7577241059,"cno":7577241059,"email":"","ename":"","eno":"","pphy":"DAJAO, RISE FAITH E  ","ppno":7574836401,"pcpadd":"4053 Taylor Rd,Ste K","pcpcity":"CHESAPEAKE  ","pcpstate":"VA","pcpzip":233215526,"pcpcounty":"","pcpid":"P0110907","pcpname":"FIRST CARE PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"3137 BRUNO DR  ","madd2":"","madd3":"","mcity":"CHESAPEAKE  ","mstate":"VA","mzip":"23323-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F29","R06.02","F20.9","F32.9","Z91.14","T43.96XA","R46.89","Z91.128","F20.0","Y92.9","T43.226A","R41.83","R45.850","I10","R03.0","K21.9","F20.3","Z79.899","Z02.89","R45.89","Z20.828","F71","G44.209","R51.9","R06.00","Z20.822","F84.0"],"date":["2020-03-02","2020-01-30","2021-06-16","2021-06-16","2020-02-18","2020-02-18","2020-06-09","2020-06-09","2021-08-10","2020-06-09","2020-06-09","2020-06-09","2021-06-18","2020-06-09","2020-06-10","2020-06-10","2020-06-09","2021-08-10","2020-11-21","2020-11-21","2020-11-21","2020-11-22","2020-11-22","2020-11-23","2021-03-26","2021-06-16","2021-06-16"],"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":[["","93317431","ALBUTEROL SUL","FAT E","","Select","Select",""],["","61874013030","VRAYLAR","CAP 3MG","","Select","Select",""],["","16729016901","ESCITALOPRAM","TAB 10MG","","Select","Select",""],["","65757040403","ARISTADA","INJ 1064MG","","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","","Select","Select",""],["","59762531001","PRAZOSIN HCL","CAP 1MG","","Select","Select",""],["","60505006501","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","59762531001","PRAZOSIN ","CAP 1MG","30","Select","Select",""],["","68382080510","TRAZODONE ","TAB 50MG","30","Select","Select",""],["","93317431","ALBUTEROL ","FAT E","8.5","Select","Select",""],["","16729016901","ESCITALOPRAM ","TAB 10MG","30","Select","Select",""],["","61874013030","VRAYLAR ","CAP 3MG","30","Select","Select",""],["","65757040403","ARISTADA ","INJ 1064MG","3.9","Select","Select",""],["","60505006501","OMEPRAZOLE ","CAP 20MG","14","Select","Select",""],["","62756079813","DIVALPROEX ","500MG DR","63","Select","Select",""],["","59762531001","PRAZOSIN","1MG","30","Select","Select",""],["","00093317431","ALBUTEROL","E","8.5","Select","Select",""],["","13668021990","ARIPIPRAZOLE","15MG","30","Select","Select",""],["","62756079813","DIVALPROEX","500MG DR","63","Select","Select",""],["","13668021990","ARIPIPRAZOLE ","TAB 15MG","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":""}]}]}