{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMES L SMITH","gend":0,"add":"10256 JENNINGS  LANE ","city":"HAYES ","state":"VA","zip":"23072-9998","dob":"1950-01-06","age":"","mstatus":"","insh":11014985,"cliId":"8P89MT3YP28","pno":7576904733,"cno":7576904733,"email":"","ename":"","eno":"","pphy":"STONE, ERIC ","ppno":8046426171,"pcpadd":"856 J Clyde Morris Blvd Ste A","pcpcity":"Newport News","pcpstate":"VA","pcpzip":236011318,"pcpcounty":"","pcpid":"P9059011","pcpname":"RIVERSIDE HAYES MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"TIDEWATER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"10256 JENNINGS  LANE ","madd2":"","madd3":"","mcity":"HAYES ","mstate":"VA","mzip":"23072-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["M25.512","I10","R42","F17.210","D64.9","Z91.14","R07.81","W19.XXXA","N28.9","W10.8XXD","J41.0","R07.9","Z00.00","I44.4","Z91.19","R00.0","R32","R79.89","R94.6","Z91.81","F17.200","Z71.6"],"date":["2021-05-26","2021-10-27","2020-08-03","2021-05-26","2021-10-27","2020-08-03","2020-10-09","2020-09-26","2020-09-30","2020-10-09","2020-10-09","2020-11-09","2020-11-09","2020-11-09","2021-10-27","2021-02-22","2021-02-22","2021-05-26","2021-05-26","2021-10-27","2021-10-27","2021-10-27"],"priorHcc":["",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":[["","43547033810","BENAZEPRIL","TAB 40MG","","Select","Select",""],["","378087199","CLONIDINE","DIS 0.1\/24HR","","Select","Select",""],["","591288601","VERAPAMIL","CAP 360MG SR","","Select","Select",""],["","59746017306","PREDNISONE","TAB 10MG","","Select","Select",""],["","65162003310","APAP\/CODEINE","TAB 300-30MG","","Select","Select",""],["","70461012003","FLUAD QUADRI","INJ 0.5ML","","Select","Select",""],["","43547033810","BENAZEPRIL ","TAB 40MG","90","Select","Select",""],["","378087199","CLONIDINE ","DIS 0.1\/24HR","4","Select","Select",""],["","591288601","VERAPAMIL ","CAP 360MG SR","90","Select","Select",""],["","59746017306","PREDNISONE ","TAB 10MG","14","Select","Select",""],["","70461012003","FLUAD ","INJ 0.5ML","0.5","Select","Select",""],["","65162003310","APAP\/CODEINE ","TAB 300-30MG","30","Select","Select",""],["","16571020110","DICLOFENAC ","75MG DR","60","Select","Select",""],["","70461012103","FLUAD","2021-22","0.5","Select","Select",""],["","16571020110","DICLOFENAC","75MG DR","60","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":""}]}]}