{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" A EINNANOSNHOJ","gend":1,"add":"        DR OROBLAOC 00621                         ","city":"CHESTERFIELD             ","state":"VA","zip":"23838-9998","dob":"1945-05-22","age":"","mstatus":"","insh":"00112251","cliId":"","pno":"3740801349","cno":"","email":"","ename":"","eno":"","pphy":"PAUL, CHRISTINE E","ppno":8042307777,"pcpadd":"4730 N SOUTHSIDE PLAZA ST,STE 1B","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232241742,"pcpcounty":"","pcpid":"","pcpname":"VCUHS HAYES E WILLIS HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"12600 COALBORO RD                                 ","madd2":"                                                  ","madd3":"","mcity":"CHESTERFIELD             ","mstate":"VA","mzip":"23838-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J06.9","E11.42","L84","M20.41","R94.31","E11.9","I10","E78.5","M81.0","Z79.4","Z86.69","R07.89","N39.0","B35.8","L90.0","N90.89","N76.6","Z01.810","I25.2","Z01.812","E55.9","E78.00","H61.23","H81.90","K08.409","M21.611","M21.612","Z68.22","Z79.82","Z79.83","H25.13","C51.9","Z48.3","R35.0","I25.10","R07.9","R06.02","I73.9","S70.01XA","W01.0XXA","Z79.84","R05","R30.0","E11.65","E11.29","R80.9","Z20.828","I25.118","R94.39","Z12.31","L97.511","R42","Z98.890","N90.4","N76.2","R51","C51.0","I25.84","E11.621","C51.8","M54.6","H81.10","Z23","J02.9","E04.2","M19.90","Z20.822","Z79.899","Z88.0","M20.42","B35.1","H66.90","L23.7","Z13.89","G89.11","L30.9","B35.6","N89.8","Z78.9","E83.42","R11.2","M21.6X1","M21.6X2","N76.89","X50.9XXA","Y93.89","Z71.3","Z78.0","N90.5","M54.50","R03.0","R94.4","Z48.816","J01.90","M79.89","R49.8","G89.3","L03.324","Z87.2","R59.0","Z51.12","E87.6","S06.5X9A","D64.9","Z85.9","R22.43","R41.82","I62.00","F03.90","S06.5X0A","R41.0","S06.5XAA","R53.81","Z51.5","Z68.21","G93.41","G93.6","D63.8","W18.30XA","R56.9","D72.829","M43.6","R47.02","Z85.44","R51.9","C57.9","S06.5X9D","R73.9","Z91.81","T45.1X5S","Z85.89","E87.2","R29.90","S06.9X9A","D44.7","I62.01","G93.5","C52","F17.200","Z79.02","H91.93","R60.0","Z74.3","Z48.811","G81.94","R13.10","R41.9","G93.40","S06.5XAD","T45.1X5D","E11.59","R50.9","R53.1"," ","I61.9","S06.5X0D","I69.154","G40.909","Z92.21","Z92.3","K76.0","R79.89","R94.5","R22.41","Z51.11"],"date":["2020-12-08","2021-05-27","2022-08-22","2020-01-29","2022-10-19","2022-11-08","2022-11-21","2022-11-08","2021-12-16","2022-11-21","2019-02-27","2020-02-29","2021-04-22","2021-04-22","2021-10-22","2021-07-23","2021-10-22","2021-11-19","2021-11-19","2021-11-19","2018-11-26","2018-11-26","2021-11-15","2018-11-26","2018-11-26","2018-11-26","2018-11-26","2018-11-26","2022-11-08","2018-11-26","2019-11-27","2022-12-02","2021-12-20","2020-01-27","2022-11-21","2022-02-10","2022-02-10","2022-04-27","2018-05-28","2018-05-28","2022-09-29","2018-09-26","2021-10-09","2022-11-21","2022-04-22","2022-04-22","2021-12-02","2022-11-08","2022-02-28","2019-03-01","2021-08-17","2019-01-25","2022-01-25","2021-07-09","2020-09-08","2018-10-27","2021-12-16","2021-12-09","2021-12-16","2022-07-28","2020-02-29","2019-06-05","2022-11-04","2019-09-19","2021-11-12","2021-12-14","2022-09-13","2022-09-29","2022-11-21","2020-01-29","2022-08-22","2019-05-13","2018-05-24","2018-05-24","2018-05-28","2021-07-09","2020-07-28","2020-12-17","2020-12-17","2019-01-25","2022-10-04","2022-01-26","2022-01-26","2020-01-27","2020-02-29","2020-02-29","2018-11-16","2022-02-28","2022-04-26","2022-05-23","2022-05-23","2022-05-23","2021-12-16","2021-12-02","2022-11-04","2022-11-08","2022-06-21","2022-06-21","2022-06-21","2022-06-28","2022-08-30","2022-08-30","2022-10-20","2022-10-20","2022-09-15","2022-09-23","2022-09-28","2022-09-29","2022-09-29","2022-10-04","2022-10-04","2022-11-04","2022-10-04","2022-10-04","2022-10-04","2022-09-29","2022-09-29","2022-11-21","2022-09-29","2022-10-20","2022-09-29","2022-10-20","2022-09-29","2022-11-21","2022-09-14","2022-09-15","2022-09-24","2022-09-24","2022-09-24","2022-09-24","2022-09-24","2022-09-24","2022-09-24","2022-10-20","2022-10-20","2022-09-13","2022-09-13","2022-09-13","2022-09-13","2022-09-13","2022-11-04","2022-10-25","2022-09-13","2022-10-04","2022-10-04","2022-11-21","2022-10-04","2022-10-04","2022-10-04","2022-10-04","2022-08-22","2022-09-14","2022-09-28","2022-12-02","2022-10-20","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08"],"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":[["","29300012810","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","29300022705","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","00093720198","PRAVASTATIN","TAB 20MG","90","Select","Select",""],["","49281040565","FLUZONE","INJ PF 19-20","0.5","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30","Select","Select",""],["","68462010630","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","55111012305","ATORVASTATIN","TAB 40MG","90.00","Select","Select",""],["","65862035705","CLOPIDOGREL","TAB 75MG","30.00","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","30.00","Select","Select",""],["","67877019810","AMLODIPINE","TAB 5MG","30.00","Select","Select",""],["","51672404003","ENALAPRIL","TAB 20MG","180","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","56151146001","TRUE","TES GLUCOSE","100","Select","Select",""],["","00006027731","JANUVIA","TAB 100MG","90","Select","Select",""],["","00378718505","METFORMIN","TAB 500MG","360","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","30","Select","Select",""],["","64980034003","ALENDRONATE","TAB 10MG","90","Select","Select",""],["","00046087221","PREMARIN","CRE 0.625MG","30","Select","Select",""],["","62037099901","POT  CL MICRO","TAB 20MEQ ER","90","Select","Select",""],["","51672125906","CLOBETASOL","OIN 0.0005","45","Select","Select",""],["","53746027205","SMZ\/TMP","TAB 800-160","6","Select","Select",""],["","17478076106","DRONABINOL","CAP 2.5MG","30","Select","Select",""],["","31722053705","LEVETIRACETA","TAB 500MG","90","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","25","Select","Select",""],["","00003089321","ELIQUIS","TAB 2.5MG","28","Select","Select",""],["","47781030701","NITROFUR","CAP 50MG","30","Select","Select",""],["","45963070911","METOPROL","TAB 25MG ER","90","Select","Select",""],["","67877012420","SILVER","CRE 0.01","20","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59762330403","NITROGLYCERN","SUB 0.4MG","25.00","Select","Select",""],["","68462018135","CLOTRIMAZOLE","CRE 0.01","30","Select","Select",""],["","59746012206","MECLIZINE","TAB 12.5MG","30","Select","Select",""],["","00006483703","PNEUMOVAX","INJ 25\/0.5","0.5","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","45802004811","NYSTATIN","OIN 100000","30","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","6","Select","Select",""],["","00574200802","NYSTOP","POW 100000","60","Select","Select",""],["","70461012103","FLUAD","INJ 2021-22","0.5","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00093220401","METOCLOPRAM","TAB 5MG","30","Select","Select",""],["","60505014202","GLIPIZIDE","TAB 10MG","180","Select","Select",""],["","13811071910","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","67877021560","CEFUROXIME","TAB 250MG","20","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":""}]}]}