{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AARON AYERS","gend":0,"add":"4061 WILL WHARF ROAD","city":"EXMORE","state":"VA","zip":"23417-1331","dob":"1919-06-29","age":"","mstatus":"","insh":11009421,"cliId":"1FW9XR2JD47","pno":7574426839,"cno":"","email":"","ename":"","eno":"","pphy":"BRADLEY, THOMAS","ppno":7577877374,"pcpadd":"20280 Market St","pcpcity":"Onancock","pcpstate":"VA","pcpzip":"23417-1331","pcpcounty":"","pcpid":"P9058920","pcpname":"ONLEY COMMUNITY HEALTH CENTER","plan":"VPHP - VIRGINIA PREMIER","program":"MEDICARE","lob":"DSNP","aligned":"Y","ano":"","add2":"APT 7","add3":"","madd1":"","madd2":"APT 7","madd3":"","mcity":"EXMORE","mstate":"VA","mzip":"23350-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["M06.9","L85.1","I73.9","H61.23","H60.331","I10","F17.200","M77.41","M77.42","M79.89","L57.0","M05.9","R35.0","L03.031","L60.0","I50.42","R60.9","M25.552","M51.36","M19.90","W19.XXXA","R13.11","R26.81","R26.89","I50.40","R41.841","I95.1"],"date":["2020-05-21","2020-02-24","2020-02-24","2020-03-30","2020-03-30","2021-05-03","2020-03-30","2020-06-01","2020-06-01","2020-06-01","2020-06-01","2020-12-01","2020-08-03","2020-09-04","2020-09-04","2021-05-14","2021-04-09","2021-05-20","2021-05-20","2021-05-20","2021-05-20","2021-05-03","2021-05-03","2021-05-03","2021-05-03","2021-05-03","2021-05-14"],"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":[["","16729018317","HYDROCHLOROT","TAB 25MG","","Select","Select",""],["","172572860","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","31722052101","HYDRALAZINE","TAB 50MG","","Select","Select",""],["","61314054701","LATANOPROST","SOL 0.00005","","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","","Select","Select",""],["","61314064610","NEO\/POLY\/HC","SOL 1% OTIC","","Select","Select",""],["","16729018317","HYDROCHLOROT ","TAB 25MG","90","Select","Select",""],["","31722052101","HYDRALAZINE ","TAB 50MG","90","Select","Select",""],["","172572860","FAMOTIDINE ","TAB 20MG","90","Select","Select",""],["","61314054701","LATANOPROST ","SOL 0.00005","7.5","Select","Select",""],["","68180012202","CEPHALEXIN ","CAP 500MG","20","Select","Select",""],["","68382013210","TAMSULOSIN ","CAP 0.4MG","30","Select","Select",""],["","60758080105","TIMOLOL ","SOL 0.5% OP","5","Select","Select",""],["","65862042005","SMZ\/TMP ","TAB 800-160","20","Select","Select",""],["","69315090405","LORAZEPAM ","TAB 0.5MG","30","Select","Select",""],["","61314064610","NEO\/POLY\/HC ","1% OTIC","10","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","",""],["No","Select","","","","","Select","",""],["N\/A","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":""}]}]}