{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOSHUA T MONEYMAKER","gend":0,"add":"398 GLENDOWER RD","city":"SCOTTSVILLE                   ","state":"VA","zip":"24590-9998","dob":"2000-06-13","age":"","mstatus":"","insh":11015639,"cliId":"9JV8Q56QA25","pno":4349646963,"cno":4343052610,"email":"","ename":"","eno":"","pphy":"RICHARD A JOYCE","ppno":4342866434,"pcpadd":"295 E Main St,","pcpcity":"Scottsville","pcpstate":"VA","pcpzip":245904995,"pcpcounty":"","pcpid":"P0124285","pcpname":"RICHARD A JOYCE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"398 GLENDOWER RD","madd2":"","madd3":"","mcity":"SCOTTSVILLE","mstate":"VA","mzip":"24590-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["R32","L22","N39.42","N39.46","R39.81","N32.81","N31.9","Q05.9","R39.14","G90.09","N30.01","A41.9","T83.518A","Y84.6","B96.20","Q07.01","N31.2","Z28.21","Z91.018","Z91.040","Z98.2","Z23","Q05.2","R26.89","M24.562","M24.561","I10","H16.253","H01.00A","H01.00B"],"date":["2021-01-29","2021-05-16","2021-05-16","2021-05-16","2021-05-16","2021-05-16","2021-10-04","2021-10-04","2021-10-04","2021-04-06","2020-10-10","2020-10-08","2020-10-08","2020-10-08","2020-10-08","2020-10-08","2020-10-08","2020-10-08","2020-10-08","2020-10-08","2021-04-19","2021-04-08","2021-04-19","2021-04-19","2021-04-19","2021-04-19","2021-08-12","2021-09-23","2021-09-23","2021-09-23"],"priorHcc":["","","","","","",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":[["","24208083060","NEO\/POLY\/DEX","SUS 0.1% OP","","Select","Select",""],["","68382013210","TAMSULOSIN","CAP 0.4MG","","Select","Select",""],["","62175027137","OXYBUTYNIN","TAB 10MG ER","","Select","Select",""],["","24208083060","NEO\/POLY\/DEX ","SUS 0.1% OP","5","Select","Select",""],["","68382013210","TAMSULOSIN ","CAP 0.4MG","30","Select","Select",""],["","62175027137","OXYBUTYNIN ","TAB 10MG ER","30","Select","Select",""],["","72578000105","DOXYCYCL","100MG","30","Select","Select",""],["","00023916330","RESTASIS","0.05%","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","",""],["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":""}]}]}