{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"YLREBMIKGNUOY D ","gend":1,"add":"    ENAL DOOWREBMIT   043                         ","city":"CHARLOTTESVILLE          ","state":"VA","zip":"22903-9998","dob":"1969-01-10","age":"","mstatus":"","insh":"00110488","cliId":"","pno":"2443442612","cno":4349606745,"email":"","ename":"","eno":"","pphy":"KON, RACHEL H","ppno":8002239173,"pcpadd":"LEE STREET AND 11TH STREET SW,","pcpcity":"Charlottesville","pcpstate":"VA","pcpzip":229080001,"pcpcounty":"","pcpid":"","pcpname":"UVA HOSPITAL","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"UNIT 301                                          ","add3":"","madd1":"340   TIMBERWOOD LANE                             ","madd2":"UNIT 301                                          ","madd3":"","mcity":"CHARLOTTESVILLE          ","mstate":"VA","mzip":"22903-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K59.00","R11.2","R10.84","K21.9","I10","I25.2","E11.9","Z87.891","S89.92XA","M17.11","E11.65","R69","F31.31","M79.661","M79.604","I73.9","H52.7","Z79.899","R31.0","N20.0","Z87.440","R10.9","Z74.3","R06.83","Z91.89","R06.89","R40.0","R53.82","G47.00","R53.83","Z20.828","M79.605","R10.13","D18.03","R52","M17.0","H35.039","E78.5","R91.8","N30.00","R10.32","E86.0","N17.9","E87.2","F17.210","R06.02","N10","U07.1","Z12.31","F33.3","E78.00","M25.561","G89.29","F33.9","M79.89","S89.91XA","W19.XXXA","L30.4","R31.9","R09.02","J22","J12.89","M54.5","R53.1","R26.2","R10.31","J45.909","F32.9","G47.61","Z12.11","Z00.00","A05.9","D64.9","Z79.84","B34.9","R73.09","R30.0","M54.50","S99.919A","R11.0","G25.81","R11.10","R10.30","Z20.822","R22.41","W01.0XXA","Y92.512","G47.39","R79.89","R07.89"," ","N39.0","R07.9","K66.1","Z87.442"],"date":["2022-10-14","2022-04-28","2022-10-14","2022-10-14","2022-10-14","2022-11-05","2022-11-05","2022-11-05","2022-03-07","2022-04-14","2022-10-14","2022-12-11","2022-03-17","2021-07-28","2022-05-17","2021-07-28","2020-11-03","2020-11-03","2021-06-11","2022-11-05","2021-05-13","2022-11-05","2022-11-05","2020-06-28","2020-06-28","2020-06-28","2020-06-28","2020-06-28","2020-06-28","2021-04-23","2020-08-13","2022-05-17","2022-04-28","2022-04-28","2022-04-28","2020-03-05","2020-10-07","2022-10-26","2020-08-18","2021-09-06","2020-04-27","2020-04-27","2020-04-27","2020-04-27","2020-04-27","2020-04-27","2020-08-18","2020-08-25","2022-10-14","2019-10-29","2020-08-18","2022-03-07","2020-08-25","2021-11-18","2022-03-07","2022-03-07","2022-03-07","2020-10-07","2020-08-25","2020-08-19","2020-08-19","2020-08-25","2021-07-14","2020-08-25","2020-08-25","2020-08-25","2020-08-25","2020-08-25","2020-08-25","2022-05-17","2021-04-23","2020-04-28","2021-04-23","2020-08-18","2020-08-13","2021-09-06","2019-10-20","2022-03-07","2022-03-07","2021-07-14","2021-07-14","2021-09-06","2021-09-06","2021-09-06","2020-07-10","2022-03-07","2022-03-07","2020-06-28","2020-04-27","2022-10-14","2022-12-11","2022-11-05","2022-11-05","2022-11-05","2022-11-05"],"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":[["","68382009305","CARVEDILOL","TAB 6.25MG","180","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","14","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","43547040011","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","65862020399","LOSARTAN","TAB 100MG","30","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","15","Select","Select",""],["","16571041250","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","57599080000","FREESTY","KIT 2 SENSOR","2","Select","Select",""],["","60505257908","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","43598071910","CHLORTHALID","TAB 25MG","90","Select","Select",""],["","00172572870","FAMOTIDINE","TAB 20MG","30","Select","Select",""],["","60505014201","GLIPIZIDE","TAB 10MG","90","Select","Select",""],["","00597015330","JARDIANCE","TAB 25MG","90","Select","Select",""],["","45802016000","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","53885001110","ONETOUCH","MIS PLUS 30G","100","Select","Select",""],["","00169406013","VICTOZA","INJ 18MG\/3ML","9","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","00378700493","PAROXETINE","TAB 40MG","30","Select","Select",""],["","53746051110","SPIRONOLACT","TAB 25MG","90","Select","Select",""],["","16729018317","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","68382012205","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","69238131109","PREGABALIN","CAP 50MG","90","Select","Select",""],["","00093720210","PRAVASTATIN","TAB 40MG","90","Select","Select",""],["","00006027754","JANUVIA","TAB 100MG","90","Select","Select",""],["","45802008801","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","68180051703","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","53885004401","ONE","KIT VERIO FL","1","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","2","Select","Select",""],["","10572010001","PEG-3350","SOL ELECTROL","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":["",""],"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":""}]}]}