{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NIVLEMNELLA ","gend":0,"add":"   EVA WEIV DNALHGIH 6011                         ","city":"RICHMOND                 ","state":"VA","zip":"23222-9998","dob":"1948-06-22","age":"","mstatus":"","insh":"00113761","cliId":"","pno":"2840866292","cno":8044474661,"email":"","ename":"","eno":"","pphy":"COVINGTON, DAMIAN L","ppno":8042257177,"pcpadd":"1510 N 28TH ST STE 300,","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232235311,"pcpcounty":"","pcpid":"","pcpname":"DOMINION MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1106 HIGHLAND VIEW AVE                            ","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":["B19.20","K75.9","F52.21","I10","Z09","R35.1","R06.02","I11.9","R79.9","E53.8","R53.1","R63.4","E55.9","B35.1","E11.65","N39.0","R31.9","M79.609","R89.9","Z92.29","R79.89","R68.89","Z68.31","G62.9","F19.20","J32.9","Z68.28","M19.90","K74.60","F10.21","Z86.19","B18.2","M20.11","M20.12","Q66.89","B97.89","K59.09","R10.84","K59.00","M54.9","Z00.00","R77.2","Z23","K76.89","K80.20","N13.30","N23","R42","B18.9","G60.9","K08.409","K59.03","K64.9","S02.5XXD","T37.5X5S","Z68.26","Z79.82","Z79.899","D69.6","Z13.89","K76.0","Z71.89","F52.22","H81.10","N20.0","R30.0","J30.9","R31.0","R80.9","Z68.30","L60.2","L03.031","L03.032","L20.9","K21.9","R94.31","S20.229A","J06.9","M54.5","Z68.29","M47.816","I70.213","M77.9","Z87.448","N20.1","R05.9","M77.8","M72.2"," "],"date":["2020-03-18","2022-11-03","2022-11-03","2022-11-03","2019-03-14","2022-08-04","2022-08-04","2022-11-03","2022-11-03","2022-08-04","2020-07-20","2020-07-20","2022-08-04","2022-02-02","2022-02-02","2022-02-02","2022-05-03","2022-11-03","2022-11-03","2022-11-03","2022-11-03","2022-11-03","2021-02-03","2021-02-03","2021-05-03","2020-02-04","2020-07-20","2020-07-20","2021-08-09","2020-02-17","2020-02-17","2018-05-11","2021-03-03","2021-03-03","2021-03-03","2018-03-04","2018-03-04","2018-03-04","2018-03-30","2021-08-09","2020-07-20","2018-03-16","2018-03-16","2020-03-18","2021-08-09","2020-03-18","2022-05-03","2020-04-15","2018-04-24","2018-04-24","2018-04-24","2018-04-24","2018-04-24","2018-04-24","2018-04-24","2018-04-24","2018-04-24","2018-04-24","2021-05-03","2021-05-03","2018-05-11","2018-05-11","2019-06-10","2019-06-10","2022-04-20","2021-06-22","2020-08-20","2021-08-09","2021-08-02","2021-08-02","2019-08-13","2019-08-13","2019-08-13","2020-08-20","2020-08-20","2022-08-04","2020-11-23","2019-10-15","2020-11-16","2022-08-04","2020-11-06","2019-12-05","2019-12-05","2022-02-24","2022-03-01","2022-05-09","2022-09-14","2022-10-26","2022-11-03"],"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":[["","65162010250","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","30","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","48","Select","Select",""],["","59651000205","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","60","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","90.00","Select","Select",""],["","00168002031","HYDROCORT","OIN 0.01","28.35","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","49281012165","FLUZONE","INJ 2021-22","0.7","Select","Select",""],["","59267102501","PFIZER","INJ ADLT RTU","0.3","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","10.00","Select","Select",""],["","70461012203","FLUAD","INJ 2022-23","0.5","Select","Select",""],["","00005200010","PREVNAR","INJ ","0.5","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","67877021620","CEFUROXIME","TAB 500MG","6.00","Select","Select",""],["","00143928501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","55111068405","IBU","TAB 800MG","90","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","88","Select","Select",""],["","00781577626","AZITHROMYCIN","TAB 250MG","6","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":""}]}]}