{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"V HALUEBNOSDOOW ","gend":1,"add":"          EVA YDNALB 6011                         ","city":"RICHMOND                 ","state":"VA","zip":"23225-9998","dob":"1941-12-23","age":"","mstatus":"","insh":"00111412","cliId":"","pno":"3240877021","cno":"","email":"","ename":"","eno":"","pphy":"MULLET, EMILY K","ppno":8042307777,"pcpadd":"4730 N SOUTHSIDE PLAZA ST,","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232241742,"pcpcounty":"","pcpid":"","pcpname":"VCUHS HAYES E WILLIS HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"N","ano":"","add2":"                                                  ","add3":"","madd1":"1106 BLANDY AVE                                   ","madd2":"                                                  ","madd3":"","mcity":"RICHMOND                 ","mstate":"VA","mzip":"23225-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L03.113","L02.413","B95.61","E78.5","I10","I49.5","I48.0","E87.6","D69.6","D72.819","L03.116","L08.9","M79.89","R11.2","R10.13","J18.9","R06.00","H60.91","E87.1","H66.011","J12.3","M13.80","D64.9","B97.81","J15.9","H66.90","M62.81","R26.2","Z79.2","Z95.0","J12.89","M79.661","M25.561","Z86.2","Z85.6","M85.80","Z79.01","M17.11","M79.669","Z87.01","Z45.010","Z79.82","I48.91","M85.9","Z09","Z87.2","R41.3","M81.0","R63.4","L02.818","R94.31","I49.3","K44.9","I49.9","I44.0","I48.19","R91.8","R50.9","R00.0","N17.9","R21","I49.1","S32.028A","W18.30XA","R10.9","R19.7","I48.1","E87.8","Z45.018","M25.661","M25.651","H61.23","R55","Z79.899","Z68.22","Z88.2","Z82.49","M17.12","S30.0XXA","S70.02XA","M48.56XA","M54.5","W10.9XXA","A41.89","E27.40","E86.0","H66.41","E86.1","Z96.1","J98.4","M19.011","M19.012","H91.91","Z23","D51.8","M80.00XD","I45.9","Z98.890","H66.91","E83.51","R53.1","M19.90","Z68.23","R39.81","F32.9","M25.361","Z12.11","K64.8","K57.30","D17.5","L53.9","R65.10","L27.0","I48.2","M25.552","S32.020A","I48.20","Z79.1","M84.48XA","W01.0XXA","K76.0","R29.6","S32.010A","W18.11XA","Z04.3","S32.021A","S32.011A","R42","M54.9","R31.9","W19.XXXS","R31.1","R47.89","R31.21","R31.29","T14.90XA","A41.9","E86.9","Z90.710","Z90.79","Z90.722","Z98.41","S32.029B","Z88.5","N32.89","Z87.39","Z86.79","M80.08XD","W19.XXXD","Z91.81","N28.89","K31.89","I51.7","I70.90","R00.1","M54.50","R03.0"," ","R77.9"],"date":["2020-03-20","2020-04-02","2020-03-20","2022-10-26","2022-10-26","2022-12-04","2022-10-26","2021-10-18","2020-03-20","2022-10-26","2018-04-26","2018-04-20","2020-03-19","2019-08-14","2019-08-14","2019-10-30","2019-08-17","2019-08-17","2019-08-17","2019-08-22","2019-08-22","2020-08-21","2022-07-25","2019-09-19","2019-09-19","2019-09-19","2021-07-08","2019-09-19","2019-09-01","2022-12-04","2019-09-01","2021-09-13","2022-01-13","2021-09-13","2021-09-13","2022-06-29","2022-03-15","2021-10-15","2021-10-15","2019-10-30","2022-08-29","2022-05-03","2022-03-15","2020-02-20","2020-04-06","2020-04-06","2022-12-01","2022-07-25","2018-09-27","2020-08-13","2021-05-19","2019-08-14","2019-08-15","2019-08-17","2019-08-17","2019-11-21","2019-08-17","2020-03-19","2018-04-20","2018-04-22","2018-04-22","2021-05-19","2021-05-02","2022-03-17","2019-08-14","2019-08-14","2019-09-17","2019-09-17","2022-08-29","2021-07-08","2021-07-08","2019-08-12","2020-03-19","2022-03-11","2020-03-19","2020-03-19","2020-03-19","2018-04-21","2021-05-01","2021-05-01","2022-03-15","2021-05-02","2021-05-02","2019-08-17","2019-08-17","2019-08-17","2019-08-17","2019-08-17","2019-08-17","2019-08-17","2019-08-17","2019-08-17","2019-10-02","2019-10-02","2022-10-26","2022-10-26","2018-01-24","2020-03-21","2019-09-12","2018-04-26","2022-03-17","2019-10-16","2019-10-16","2019-10-16","2020-10-29","2020-10-29","2019-12-27","2019-12-27","2019-12-27","2019-12-27","2018-04-12","2018-04-20","2018-04-21","2018-04-21","2021-05-02","2022-03-15","2021-06-11","2022-03-11","2022-03-17","2022-03-15","2022-03-15","2022-03-15","2022-03-17","2022-03-15","2022-03-15","2022-03-17","2022-03-17","2022-05-03","2022-03-17","2022-03-17","2022-04-27","2022-05-03","2022-03-17","2022-06-29","2022-06-29","2022-03-15","2018-04-21","2018-04-21","2022-06-29","2018-04-21","2018-04-21","2018-04-21","2022-03-16","2022-07-25","2022-06-29","2022-06-29","2022-06-29","2022-05-03","2022-05-03","2022-05-03","2022-06-29","2022-06-29","2022-06-29","2022-06-29","2022-07-25","2022-03-17","2022-03-17","2022-12-04","2022-11-22"],"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":[["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00832532411","POT  CL MICRO","TAB 10MEQ ER","90","Select","Select",""],["","67877019805","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","68462019805","PRAVASTATIN","TAB 80MG","30","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","5","Select","Select",""],["","00378214605","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","00228255006","DICLOFENAC","TAB 50MG DR","30","Select","Select",""],["","50458057930","XARELTO","TAB 20MG","30","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","45802011222","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","00093314701","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","80777028299","MODERNA","INJ BA4\/BA5","0.5","Select","Select",""],["","66685100101","AMOX\/K","TAB 875-125","19","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","62175044601","PEG","SOL ELECTROL","4,000.00","Select","Select",""],["","00781152601","POT  CHLORIDE","TAB 10MEQ CR","60","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":""}]}]}