{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SUSAN   L KNAPP","gend":1,"add":"5500 IRON BRIDGE ROAD","city":"RICHMOND","state":"VA","zip":"23234-9998","dob":"1953-06-27","age":"","mstatus":"","insh":"900045852*01","cliId":"","pno":"804\/938-8426","cno":"","email":"","ename":"","eno":"","pphy":"GOODMAN, JULIE NP","ppno":"804\/717-5300","pcpadd":"STE 117 11601 IRONBRIDGE RD","pcpcity":"CHESTER","pcpstate":"VA","pcpzip":23831,"pcpcounty":"","pcpid":"","pcpname":"IRONBRIDGE FAMILY PRACTICE","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/748-7269","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F41.9","L85.3","I70.203","B35.1","L85.9","R46.0","I10.","Z90.5","G31.84","F25.0","R41.89","F41.1","Z86.59","R26.89","F68.8","R46.89","N18.2","F31.9","Z68.1","R82.90","F31.73","Z12.11","I70.0","H10.021","G30.0","F32.1","F02.80","Z79.899","J02.9","J06.9","Z00.00","I25.10","E78.2","Z72.0","L60.2","N20.0"],"date":["2021-05-19","2021-07-01","2021-07-01","2021-07-01","2021-07-01","2021-07-01","2021-08-04","2021-08-18","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-12-06","2021-07-01","2021-07-01","2021-08-04","2021-07-01","2021-10-06","2021-06-04","2021-07-12","2021-10-30","2021-12-06","2021-12-06","2021-12-06","2021-03-09","2021-11-01","2021-11-01","2021-06-04","2021-08-04","2021-08-04","2021-06-04","2021-06-04","2021-08-18"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"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":[]},{"a":[]},{"a":[]}]},{"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":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","50111045001","TRAZODONE HYDROCHLORIDE                                               ","150MG","30","Select","Select",""],["","42806015905","HYDROXYZINE HYDROCHLORIDE                                             ","10MG","-30","Select","Select",""],["","50458056201","INVEGA SUSTENNA                                                       ","117\/0.75","1","Select","Select",""],["","70377002911","ATORVASTATIN CALCIUM                                                  ","40MG","90","Select","Select",""],["","68180098103","LISINOPRIL                                                            ","20MG","90","Select","Select",""],["","50383077504","LIDOCAINE VISCOUS                                                     ","2% VISC","100","Select","Select",""],["","24208031510","POLYMYXIN B SULFATE\/TRIMETHOPRIM SULFATE                              ","TRIMETHP","10","Select","Select",""]]}},{"a":[]},{"a":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"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":"","a13":""}]}]}