{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"M LEINADRETSOF ","gend":1,"add":"          EVORG HCAEP 827                         ","city":"                         ","state":"VA","zip":"23148-9998","dob":"1981-02-07","age":"","mstatus":"","insh":"00113473","cliId":"","pno":"3240817458","cno":"","email":"","ename":"","eno":"","pphy":"TSUI, ALLEN Y","ppno":8044435378,"pcpadd":"1362 TAPPAHANNOCK BLVD,  ","pcpcity":"Tappahannock","pcpstate":"VA","pcpzip":225609309,"pcpcounty":"","pcpid":"","pcpname":"TAPPAHANNOCK PRIMARY CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"N","ano":"","add2":"                                                  ","add3":"","madd1":"728 PEACH GROVE                                   ","madd2":"                                                  ","madd3":"","mcity":"SAINT STEPHENS CHURC     ","mstate":"VA","mzip":"23148-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R73.03","F20.3","I10","H04.123","N39.0","M26.609","F31.9","J45.20","E03.9","R42","K62.89","R19.7","H60.332","M79.602","E66.01","G44.209","B35.1","R63.4","R35.0","E11.8","R21","G44.329","K04.7","L03.90","S81.802A","R11.2","R39.81","N39.44","E88.81","E78.5","G40.909","Z71.3","Z71.89","L03.116","K64.0","E03.1","L02.416","S81.802D","R32","L03.119","Z79.899","R60.9","E78.2","Z23","J02.9","N32.89","N32.81","K05.10","Z13.220","B35.6","E55.9","Z68.41","B37.2","Z79.2","M79.89","N50.82","F41.9","E11.65","M79.10","B07.9","Z68.42","H93.12","K64.9","K59.00","R56.9","L03.311","W45.0XXA","R10.31","F99","M17.0","Z13.21","Z76.89","K06.8","Z11.59","Z86.69","R68.82","B37.9","Z78.9","D72.829","J45.909","Z79.51","R11.10","F32.1","J45.990","E63.8","U07.1","T14.8XXA"],"date":["2022-07-05","2022-07-05","2022-07-05","2021-08-09","2020-11-23","2021-09-07","2022-07-05","2021-09-07","2022-07-05","2020-05-19","2020-05-19","2020-09-29","2021-07-26","2020-12-16","2021-12-27","2020-06-17","2021-08-09","2021-01-20","2021-06-30","2021-01-20","2021-01-20","2021-01-20","2022-07-11","2021-06-30","2021-06-30","2021-12-28","2021-11-29","2021-11-29","2021-11-16","2019-09-19","2019-09-19","2020-02-14","2020-02-14","2022-02-10","2020-04-24","2022-07-05","2022-02-10","2020-04-03","2021-06-11","2021-06-11","2021-12-27","2021-09-21","2021-09-21","2019-10-22","2021-08-25","2021-08-25","2021-08-09","2021-08-09","2021-08-09","2021-07-08","2020-05-27","2020-05-27","2021-12-28","2021-12-27","2021-12-27","2020-12-23","2021-03-02","2021-07-08","2021-07-08","2020-02-25","2020-02-25","2020-11-16","2022-07-05","2020-11-16","2022-07-05","2021-04-05","2021-03-29","2021-07-26","2022-07-05","2021-08-17","2019-11-25","2021-04-05","2021-06-30","2021-06-30","2019-11-25","2020-06-29","2020-06-29","2020-02-18","2021-12-27","2021-12-27","2021-12-27","2021-05-03","2022-07-11","2022-07-05","2022-07-05","2021-09-03","2022-04-14"],"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":[["","76204020025","ALBUTEROL","NEB 0.00083","300","Select","Select",""],["","00121058104","HALOPERIDOL","CON 2MG\/ML","180","Select","Select",""],["","64980032430","PROCTOZONE","CRE -HC 2.5%","30","Select","Select",""],["","68382013905","TOPIRAMATE","TAB 50MG","180","Select","Select",""],["","52817081615","ACETIC","SOL 2% OTIC","15","Select","Select",""],["","00093005301","BUSPIRONE","TAB 5MG","90","Select","Select",""],["","63402030230","LATUDA","TAB 20MG","30","Select","Select",""],["","69238183207","LEVOTHYROXIN","TAB 75MCG","90","Select","Select",""],["","00469260130","MYRBETRIQ","TAB 25MG","90","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","29300012601","BISOPROL","TAB 5MG","90","Select","Select",""],["","45802088094","NYSTAT\/TRIAM","CRE ","30","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","1.5","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","57237000630","FLUCONAZOLE","TAB 200MG","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","51862006205","DIAZEPAM","TAB 2MG","14","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","60","Select","Select",""],["","67877024901","QUETIAPINE","TAB 50MG","90","Select","Select",""],["","00115168974","BUDESONIDE","SUS 0.5MG\/2","60","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","60505014102","GLIPIZIDE","TAB 5MG","180","Select","Select",""],["","00316022130","NYSTATIN","CRE 100000","30","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","65862014505","CARVEDILOL","TAB 25MG","60","Select","Select",""],["","51224000760","METFORMIN","TAB 500MG ER","90","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","51672128202","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","00115551110","FENOFIBRATE","TAB 54MG","90","Select","Select",""],["","67877021620","CEFUROXIME","TAB 500MG","14","Select","Select",""],["","57237004105","PENICILLN","TAB 500MG","30","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","53746051105","SPIRONOLACT","TAB 25MG","90","Select","Select",""],["","00169430713","RYBELSUS","TAB 7MG","30","Select","Select",""],["","43547034150","RISPERIDONE","TAB 1MG","30","Select","Select",""],["","59651030901","FLUOXETINE","TAB 20MG","30","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","15","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0.5","Select","Select",""],["","68462018147","CLOTRIMAZOLE","CRE 0.01","135","Select","Select",""],["","68382050010","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","33342006807","OLANZAPINE","TAB 5MG","30","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","30","Select","Select",""],["","00713031788","CICLOPIROX","SOL 0.08","6.6","Select","Select",""],["","66685100100","AMOX\/K","TAB 875-125","14","Select","Select",""],["","69238161606","OFLOXACIN","DRO 0.3%OTIC","10","Select","Select",""],["","00006057761","JANUMET","TAB 50-1000","60","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","60","Select","Select",""],["","00193658621","MICROLET","MIS LANCETS","100","Select","Select",""],["","70954000520","OXYBUTYNIN","TAB 5MG","30","Select","Select",""],["","00193731221","CONTOUR","TES NEXT","100","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","00378210001","LOPERAMIDE","CAP 2MG","20","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","48","Select","Select",""],["","33342005407","PIOGLITAZONE","TAB 15MG","90","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}