{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DAVID J RYMAN","gend":0,"add":"503 MAGNOLIA AVE  ","city":"BUENA VISTA ","state":"VA","zip":"24416-9998","dob":"1969-03-05","age":"","mstatus":"","insh":11010777,"cliId":"2GQ7N05DC72","pno":5402616555,"cno":5402616555,"email":"","ename":"","eno":"","pphy":"HAMILTON, THOMAS F","ppno":5402677421,"pcpadd":"2252 Magnolia Ave","pcpcity":"Buena Vista ","pcpstate":"VA","pcpzip":244163122,"pcpcounty":"","pcpid":"P0117978","pcpname":"BUENA VISTA MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"503 MAGNOLIA AVE  ","madd2":"","madd3":"","mcity":"BUENA VISTA ","mstate":"VA","mzip":"24416-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["Z01.818","K02.9","F72","I10","G40.909","G47.30","R39.81","G40.89","K04.7","R50.9","F73","F79","Z13.31","R47.81","R32","Z68.27","L91.8","Z23","H10.32"],"date":["2020-01-24","2020-01-30","2020-01-30","2021-03-16","2021-09-23","2020-02-07","2021-11-06","2021-11-06","2020-08-06","2020-08-06","2021-09-23","2020-02-07","2020-02-07","2020-02-07","2020-02-07","2020-02-07","2021-08-24","2021-09-23","2021-10-05"],"priorHcc":["","","","","","",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":[["","68382002210","ATENOLOL","TAB 25MG","","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","","Select","Select",""],["","13668026810","CARBAMAZEPIN","TAB 200MG","","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","68382002210","ATENOLOL ","TAB 25MG","90","Select","Select",""],["","65862001501","AMOXICILLIN ","TAB 875MG","20","Select","Select",""],["","13668026810","CARBAMAZEPIN ","TAB 200MG","360","Select","Select",""],["","68180016013","AZITHROMYCIN ","250MG","6","Select","Select",""],["","68180012202","CEPHALEXIN","500MG","30","Select","Select",""],["","68180012202","CEPHALEXIN ","CAP 500MG","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","",""],["Yes","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":""}]}]}