{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CORINE MORGAN","gend":1,"add":"90 KING AVE ","city":"WARFIELD ","state":"VA","zip":"23889-9998","dob":"1945-02-19","age":"","mstatus":"","insh":11012730,"cliId":"6FA1JA4HV25","pno":4348650373,"cno":4348650339,"email":"","ename":"","eno":"","pphy":"PHILLIP SHOU MD","ppno":8045263821,"pcpadd":"16021 Kairos Rd Ste A","pcpcity":"South Chesterfield","pcpstate":"VA","pcpzip":238345205,"pcpcounty":"","pcpid":"P0124232","pcpname":"DR PHILLIP Y SHOU PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"90 KING AVE ","madd2":"","madd3":"","mcity":"WARFIELD ","mstate":"VA","mzip":"23889-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["R26.89","E10.59","G47.33","E11.9","I10","E78.2","G40.89","M15.0","N32.9","N39.41","E10.10","E78.5","N32.81","M25.552","E11.59","L60.8","L85.3","B35.1","M20.12","Z00.8","I45.10","R00.1","E78.00","R94.31","I95.9","H61.23","N30.80","G40.909","Z79.899","Z68.26","L60.3","E55.9","N39.0","Z01.419","Z12.72","R32","Z90.710","E03.9","R53.83","Z23","D23.71","D23.72","M21.612","Z68.25","R29.898"],"date":["2020-04-03","2021-09-17","2021-09-01","2021-08-16","2021-08-16","2021-08-16","2020-12-07","2020-05-08","2021-10-30","2021-10-30","2020-05-23","2021-08-09","2020-08-10","2020-08-10","2020-08-17","2020-08-19","2021-10-18","2020-08-19","2021-05-12","2020-12-03","2021-04-28","2021-04-28","2021-04-28","2020-09-25","2020-09-25","2020-12-07","2020-12-07","2021-03-15","2021-03-15","2021-05-12","2021-10-18","2021-08-09","2021-08-09","2021-07-28","2021-07-28","2021-07-28","2021-07-28","2021-08-09","2021-08-09","2021-10-14","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18"],"priorHcc":["","","","","","","","",null,null,"","","","","","",null,"","","","","","","","","","","","","",null,"","","","","","","","",null,null,null,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":[["","65162083366","DICLOFENAC","GEL 0.01","","Select","Select",""],["","10702020101","OXYBUTYNIN","TAB 5MG","","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","","Select","Select",""],["","61442014201","LOVASTATIN","TAB 20MG","","Select","Select",""],["","31722053712","LEVETIRACETA","TAB 500MG","","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA","","Select","Select",""],["","53885039310","ONETOUCH US","MIS LANCETS","","Select","Select",""],["","93224001","CEPHALEXIN","TAB 500MG","","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","","Select","Select",""],["","59746032530","VALACYCLOVIR","TAB 1GM","","Select","Select",""],["","45802049326","AMMONIUM LAC","CRE 0.12","","Select","Select",""],["","11822515660","RA ALCOHOL","PAD SWABS","","Select","Select",""],["","16729018201","HYDROCHLOROT ","TAB 12.5MG","90","Select","Select",""],["","65162083366","DICLOFENAC ","GEL 0.01","200","Select","Select",""],["","10702020101","OXYBUTYNIN ","TAB 5MG","180","Select","Select",""],["","61442014201","LOVASTATIN ","TAB 20MG","90","Select","Select",""],["","31722053712","LEVETIRACETA ","TAB 500MG","60","Select","Select",""],["","53885024510","ONETOUCH ","TES ULTRA","100","Select","Select",""],["","11822515660","RA ","PAD SWABS","100","Select","Select",""],["","59746032530","VALACYCLOVIR ","TAB 1GM","21","Select","Select",""],["","93224001","CEPHALEXIN ","TAB 500MG","20","Select","Select",""],["","45802049326","AMMONIUM ","CRE 0.12","385","Select","Select",""],["","65862057490","MONTELUKAST ","TAB 10MG","90","Select","Select",""],["","45802005935","NYSTATIN","100000","15","Select","Select",""],["","11822515660","RA","SWABS","100","Select","Select",""],["","45802049326","AMMONIUM","0.12","385","Select","Select",""],["","45802005935","NYSTATIN ","CRE 100000","15","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":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["Yes","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":""}]}]}