{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PAULINE SHWEWA","gend":1,"add":"6013 INDIGO RD ","city":"RICHMOND ","state":"VA","zip":"23230-9998","dob":"1937-09-22","age":"","mstatus":"","insh":11013719,"cliId":"5KU1JU1WK22","pno":9187645440,"cno":9187645440,"email":"","ename":"","eno":"","pphy":"DESHMUKH, PRAVIN M","ppno":8046122980,"pcpadd":"12320 W Broad St Ste 204","pcpcity":"Henrico  ","pcpstate":"VA","pcpzip":232337603,"pcpcounty":"Henrico","pcpid":"P0060020","pcpname":"DEPAUL MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"6013 INDIGO RD ","madd2":"","madd3":"","mcity":"RICHMOND ","mstate":"VA","mzip":"23230-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["ASIAN\/PACIFIC"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["M81.0","I71.4","I72.3","R39.81","I10","B02.29","E55.9","R79.89","E02","R73.03","G25.0","Z68.22","E78.00","M81.8","Z91.81","E78.5","H52.13","R35.1","Z85.46","E66.9","Z68.36","E03.9","Z78.0","Z13.820","Z12.31","N60.02","R92.8"],"date":["2021-11-01","2021-10-05","2021-10-05","2021-11-17","2021-06-16","2020-11-23","2020-11-23","2020-11-23","2020-11-23","2021-03-16","2021-03-16","2021-03-16","2021-06-16","2020-11-23","2020-11-23","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2020-11-13","2021-06-16","2021-06-23","2021-06-23","2021-08-10","2021-08-13","2021-08-13"],"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":[["","31722070010","LOSARTAN POT","TAB 25MG","","Select","Select",""],["","65862032904","ALENDRONATE","TAB 70MG","","Select","Select",""],["","115166001","PROPRANOLOL","TAB 20MG","","Select","Select",""],["","69238183007","LEVOTHYROXIN","TAB 25MCG","","Select","Select",""],["","55111012205","ATORVASTATIN","TAB 20MG","","Select","Select",""],["","6483703","PNEUMOVAX 23","INJ 25\/0.5","","Select","Select",""],["","64980034214","ALENDRONATE ","TAB 70MG","4","Select","Select",""],["","58160084252","BOOSTRIX ","INJ ","0.5","Select","Select",""],["","31722070010","LOSARTAN ","TAB 25MG","90","Select","Select",""],["","69238183007","LEVOTHYROXIN ","TAB 25MCG","90","Select","Select",""],["","115166001","PROPRANOLOL ","TAB 20MG","180","Select","Select",""],["","55111012205","ATORVASTATIN ","TAB 20MG","90","Select","Select",""],["","6483703","PNEUMOVAX ","INJ 25\/0.5","0.5","Select","Select",""],["","58160084252","BOOSTRIX","","0.5","Select","Select",""],["","31722070010","LOSARTAN","25MG","90","Select","Select",""],["","00006483703","PNEUMOVAX","25\/0.5","0.5","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":""}]}]}