{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TEBAZILETNUH L H","gend":1,"add":"ALOL 309EUNEVA ","city":"ALTAVISTA","state":"VA","zip":24517,"dob":"1952-04-28","age":"","mstatus":"","insh":"00110377","cliId":"","pno":"6343447863","cno":"","email":"","ename":"","eno":"","pphy":"SCANLON-ROWLETT, NICOLE R","ppno":4343636874,"pcpadd":"1280 MAIN ST ,STE A","pcpcity":"ALTAVISTA","pcpstate":"VA","pcpzip":24517,"pcpcounty":"","pcpid":"","pcpname":"ALTAVISTA MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"Western\/Charlottesville","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"903 LOLA AVENUE                                   ","madd2":"                                                  ","madd3":"","mcity":"ALTAVISTA                ","mstate":"VA","mzip":"24517-1425","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R06.00","E66.01","G47.33","J98.4","J96.01","L02.214","I10","I73.9","M25.561","M25.562","M54.9","R73.01","E78.00","K21.9","J45.909","Z68.41","E11.29","R53.83","H04.123","L73.2","L98.492","R60.0","N17.9","M79.89","R35.89","E11.22","T59.891A","R06.02","Y93.E9","Y92.009","J68.0","E11.9","Z79.84","E78.5","Z87.891","R10.84","L03.314","R06.09","L53.8","R60.9","M25.551","M62.81","R26.2","M54.41","J30.9","E11.59","E11.69","K76.0","M77.31","M77.9","M79.671","G47.30","G47.10","R06.83","R06.89","M54.5","G89.29","R26.89","Z91.81","Z87.89","Z12.31","K63.5","K62.1","I89.0","L90.5","Z23","Z00.00","Z78.0","M81.0","Z13.820","L30.1","E87.6","R05","J44.1","E11.51","M79.9","D12.5","Z86.010","R06.2","I83.893","L98.499","K42.9","R10.9","E83.52","E86.0","Z79.899","M54.50","J96.11","R94.2","K57.90","R16.0","R11.0","K57.30","E66.2","Z20.828","I15.2","Z68.37","Z28.21","R09.02","Z12.39","D72.829","D89.0","D23.112","D23.122","H25.13","I87.2","Z87.2","H01.00A","H52.03","L02.91","Z12.11","M25.50","Z13.31","R07.9","N18.30","R07.89","I95.9","I12.9","Z68.42","E66.9","R63.4","I20.8","Z20.822","R93.9","R12"," ","M16.12","M25.552"],"date":["2020-12-29","2022-12-04","2021-06-12","2022-11-22","2022-11-22","2020-11-05","2022-08-08","2022-08-09","2020-12-11","2020-06-01","2022-08-09","2020-06-15","2022-08-08","2022-08-09","2021-01-26","2022-05-21","2022-05-31","2022-05-11","2022-04-19","2020-06-15","2020-06-01","2022-05-21","2022-05-21","2022-05-21","2022-05-21","2022-12-04","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2020-11-14","2022-08-09","2022-08-09","2022-12-04","2022-08-08","2019-09-17","2019-09-20","2022-08-09","2019-09-12","2022-05-31","2022-05-11","2022-09-13","2022-09-13","2022-03-08","2020-08-25","2022-08-09","2021-05-11","2020-12-11","2021-10-05","2021-10-05","2021-10-05","2021-06-02","2021-06-02","2021-06-02","2022-05-21","2020-06-01","2020-12-11","2020-06-01","2020-06-01","2020-05-28","2021-05-25","2019-11-19","2019-11-19","2022-09-13","2022-09-13","2020-05-05","2021-11-11","2020-05-05","2020-05-05","2020-05-05","2020-05-05","2020-12-16","2020-11-19","2020-12-11","2022-08-09","2020-12-11","2019-11-19","2019-11-19","2020-01-23","2019-12-30","2019-11-12","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2022-08-08","2022-02-06","2020-12-10","2020-12-10","2021-09-15","2021-09-15","2021-09-15","2019-09-17","2020-12-08","2020-12-08","2020-12-08","2020-12-08","2020-11-05","2020-12-08","2019-07-08","2020-12-04","2022-03-07","2022-08-02","2022-08-02","2022-04-19","2020-03-19","2020-06-15","2022-04-19","2022-04-19","2019-09-20","2019-09-20","2022-03-10","2021-05-11","2022-08-09","2022-12-04","2022-08-09","2022-08-09","2022-12-04","2022-08-09","2022-05-31","2022-05-31","2022-08-11","2022-08-08","2022-08-08","2022-08-08","2022-12-04","2022-12-04","2022-12-04"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","68180096301","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","59746038306","TERAZOSIN","CAP 1MG","30","Select","Select",""],["","68645058259","METFORMIN","TAB 500MG","90","Select","Select",""],["","29300041519","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","13668010401","ISOSORB","TAB 30MG ER","30","Select","Select",""],["","68645048054","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","45802005535","TRIAMCINOLON","OIN 0.001","60","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","68645055854","LISINOP\/HCTZ","TAB 20-25MG","90","Select","Select",""],["","68645019059","METOPROL","TAB 50MG","180","Select","Select",""],["","00574200830","NYSTOP","POW 100000","30","Select","Select",""],["","00143122701","DICYCLOMINE","TAB 20MG","28","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","10","Select","Select",""],["","62332014131","CELECOXIB","CAP 100MG","60","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","14","Select","Select",""],["","42806031250","DOXYCYCL","TAB 100MG","30","Select","Select",""],["","59762374301","CLINDAMYCIN","GEL 0.01","30","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","53746027205","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4,000.00","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":["",""]}},{"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":""}]}]}