{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" G YLLIBELADSGAR","gend":0,"add":"       TS NOTGNILLEW 1282                         ","city":"RICHMOND                 ","state":"VA","zip":"23222-9998","dob":"1946-12-08","age":"","mstatus":"","insh":"00112757","cliId":"","pno":"9340802409","cno":"","email":"","ename":"","eno":"","pphy":"LATHAM-SOLOMON, VICKI","ppno":8042983460,"pcpadd":"115 S 15TH ST STE 501,","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232194258,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS CANAL CROSSING INTERNAL MEDICINE;","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"2821 WELLINGTON ST                                ","madd2":"                                                  ","madd3":"","mcity":"RICHMOND                 ","mstate":"VA","mzip":"23222-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E10.51","B35.1","B35.3","I70.213","Z12.5","M89.9","C79.51","E11.3513","H21.1X1","H43.12","I42.8","I10","I44.7","E66.01","E11.21","I35.1","E11.3413","E78.5","I34.0","C61","Z01.810","Z68.33","C79.9","Z68.30","N18.30","L60.2","L98.9","L85.8","N39.0","Z79.818","R42","Z68.34","E11.39","K13.79","M27.0","G89.3","Z51.11","E11.3593","H35.81","Z96.1","H04.123","L20.9","Z01.818","R00.1","R94.31","M25.551","Z01.812","Z20.822","E11.9","G47.30","I11.0","I25.2","I50.9","K21.9","M19.90","N41.1","E66.9","I25.10","F17.210","Z79.4","Z79.82","Z79.899","R97.20","I13.0","E11.22","R35.0","Z68.31","I73.9","Z00.00","R41.3","E11.69","E11.59","C41.4","Z87.891","E11.3553","E11.51","M17.0","H91.91","H91.92","E11.42","Z79.83","M19.041","M19.042","H04.122","M20.11","M20.12","M77.9","E11.3313","M62.81","H16.142","L30.1","Z12.11","K63.5","Z86.010","D12.3","G89.29","H59.022","Z23","N18.3","R21","L30.9","L21.9","L85.3","Z12.83","Z91.14","D63.8","M51.36","E78.00","R06.89","L60.9","M79.674","R26.2","R26.81","F33.0","F33.1","F33.9","R07.2","R06.02","R10.32","D12.6","R63.0","K59.00","R26.89","I15.2","G31.84","R93.7","E87.1","N18.9","D63.1","E11.319","Z79.84","E11.40","Z82.49"," ","N18.4","E87.5"],"date":["2022-09-23","2022-09-23","2022-09-23","2021-06-24","2021-01-05","2021-01-05","2022-10-20","2022-09-19","2022-05-26","2022-08-23","2022-07-25","2022-09-22","2022-07-25","2022-07-25","2022-11-29","2022-07-25","2022-01-18","2022-10-20","2022-07-25","2022-11-29","2022-01-18","2022-05-27","2022-11-17","2021-03-11","2021-03-23","2020-07-16","2020-01-22","2020-01-22","2021-01-27","2022-01-27","2022-01-27","2022-09-22","2022-02-28","2022-01-31","2022-02-02","2021-04-22","2021-06-03","2020-02-11","2020-02-11","2022-09-19","2022-09-19","2020-06-25","2021-03-17","2021-03-17","2021-03-17","2021-03-19","2021-03-19","2021-03-19","2021-03-23","2021-03-23","2021-03-23","2021-06-22","2022-10-20","2022-10-20","2022-10-20","2021-03-23","2021-03-23","2021-06-22","2021-03-23","2022-09-09","2021-03-23","2022-10-20","2021-03-23","2022-10-20","2022-10-20","2021-04-14","2021-04-22","2020-06-08","2020-06-10","2020-10-23","2022-09-09","2021-12-15","2021-06-22","2022-10-20","2020-06-25","2020-06-25","2020-06-25","2020-06-25","2020-06-25","2020-06-25","2020-06-25","2020-06-25","2020-06-25","2019-07-02","2020-07-16","2020-07-16","2020-07-16","2022-03-14","2022-08-31","2019-09-17","2022-09-23","2020-09-23","2019-09-10","2019-09-10","2019-09-10","2019-09-10","2022-07-12","2021-12-15","2020-09-23","2019-10-11","2019-10-11","2019-10-11","2020-10-30","2019-10-11","2020-10-23","2020-10-23","2019-12-16","2019-11-11","2019-12-02","2020-10-30","2020-10-30","2022-08-31","2022-08-31","2021-11-10","2021-11-10","2021-11-10","2019-11-11","2019-12-16","2020-12-22","2020-12-22","2020-12-22","2020-12-22","2021-12-15","2021-12-15","2019-12-16","2020-12-31","2022-05-27","2022-10-20","2022-11-29","2022-09-09","2022-09-09","2022-10-20","2022-10-20","2022-11-29","2022-11-29","2022-11-29"],"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":[["","00228212810","CLONIDINE","TAB 0.2MG","90","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","90","Select","Select",""],["","00093914801","VENLAFAXINE","TAB 37.5MG","30","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","90","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","00093321930","KETOCONAZOLE","CRE 0.02","60","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","6","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","43547040211","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","70377000712","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","76385012810","METFORMIN","TAB 500MG ER","360","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","90","Select","Select",""],["","00168000615","TRIAMCINOLON","OIN 0.001","30","Select","Select",""],["","45802041926","AMMONIUM","LOT 0.12","400","Select","Select",""],["","65862020390","LOSARTAN","TAB 100MG","90","Select","Select",""],["","00469012599","XTANDI","CAP 40MG","60","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","25","Select","Select",""],["","08627005303","DEXCOM","MIS SENSOR","3","Select","Select",""],["","70461012203","FLUAD","INJ 2022-23","0.5","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","20","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","6","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","6","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","90","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0.25","Select","Select",""],["","56151146001","TRUE","TES GLUCOSE","100","Select","Select",""],["","00093720298","PRAVASTATIN","TAB 40MG","90","Select","Select",""],["","38396030576","CVS","MIS 30G","100","Select","Select",""],["","52268001201","SUPREP","SOL PREP KIT","354","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":""}]}]}