{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JANET FAUBER","gend":1,"add":"508 ALAMO CHAPEL RD  ","city":"STEELES TAVERN ","state":"VA","zip":"24476-9998","dob":"1941-03-18","age":"","mstatus":"","insh":11017012,"cliId":"9X50T71RY03","pno":5403772069,"cno":5403772069,"email":"","ename":"","eno":"","pphy":"BEACH, BRIANA MARY","ppno":5409618040,"pcpadd":"1906 Belleview Ave SE","pcpcity":"Roanoke  ","pcpstate":"VA","pcpzip":240141838,"pcpcounty":"","pcpid":"P0144362","pcpname":"VELOCITYCARE RAPHINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"508 ALAMO CHAPEL RD  ","madd2":"","madd3":"","mcity":"STEELES TAVERN ","mstate":"VA","mzip":"24476-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["I10","E78.2","E55.9","Z00.00","R94.31","R53.83","Z23","R42","N39.0","M19.90","N30.90","R35.1"],"date":["2021-09-10","2021-09-27","2021-09-10","2021-09-10","2021-09-27","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2021-09-10","2021-06-11","2021-06-11"],"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":[["","93092806","LOVASTATIN","TAB 40MG","","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","","Select","Select",""],["","47781030801","NITROFUR MAC","CAP 100MG","","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","","Select","Select",""],["","58160082311","SHINGRIX ","INJ 50\/0.5ML","1","Select","Select",""],["","93092806","LOVASTATIN ","TAB 40MG","90","Select","Select",""],["","29300012510","MELOXICAM ","TAB 15MG","90","Select","Select",""],["","47781030801","NITROFUR ","CAP 100MG","90","Select","Select",""],["","47781030801","NITROFUR","100MG","90","Select","Select",""],["","68462026430","ROSUVASTATIN ","TAB 40MG","90","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":""}]}]}