{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YHTORODSREYM L","gend":1,"add":"ILLOH 107TEERTS SN","city":"LYNCHBURG","state":"VA","zip":24504,"dob":"1942-04-29","age":"","mstatus":"","insh":"00114968","cliId":"","pno":"0943492187","cno":"","email":"","ename":"","eno":"","pphy":"MARTIN, JO M","ppno":4349078129,"pcpadd":"1902 GRACE ST","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":24504,"pcpcounty":"","pcpid":"","pcpname":"CENTRA MEDICAL GROUP","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"WESTERN\/CHARLOTTESVILLE","aligned":"Y","ano":"","add2":"APARTMENT 311","add3":"","madd1":"701 HOLLINS STREET","madd2":"","madd3":"","mcity":"LYNCHBURG","mstate":"VA","mzip":"24504-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N61.1","M1A.0410","M25.50","M15.9","I10","R73.9","M85.831","M85.832","Z79.52","Z12.12","M10.9","M79.672","M85.80","S99.922A","M85.872","M19.072","S89.92XA","M85.862","M17.12","S99.912A","L60.0","Z12.31","M06.9","R79.89","K57.32","M25.579","R94.31","M19.90","E87.6","F14.10","Z87.891","R93.2","N28.1","N85.8","E78.00","Z87.39","M79.671","M25.571","E78.5","K21.9","Z79.899","F17.210","H40.1134","Z76.89","Z91.81","E55.9","G89.29","R09.02","R52","R60.9","G89.4","M16.0","M17.0","M15.0","M05.89","M79.10","N17.9","M79.604","M54.16","M43.16","M19.071","M51.27","M51.36","M48.07","M51.26","I73.9","M79.89","Z01.89","I37.9","M70.32","L60.2","B35.1","L60.8","M79.674","M79.675","M71.9","M81.0","Z78.0","M20.41","M79.642","M25.532","M62.830","H35.372","M12.9","E79.0","Z76.5","M79.641","Z51.81","Z96.1","Z23","M25.531","M25.572","M19.041","M10.071","M54.50","H57.10","R19.4","M79.651","M16.11","Z80.3","R53.83","M25.562","M15.8","E78.2","R53.82","M25.40","K08.89","M25.561","R73.03","Z12.11","L03.032"],"date":["2020-01-09","2020-01-09","2020-01-09","2022-03-28","2022-03-28","2020-01-09","2020-01-09","2020-01-09","2021-03-08","2020-01-09","2021-12-08","2021-07-07","2020-01-13","2020-01-13","2020-01-13","2020-01-13","2020-01-13","2020-01-13","2020-01-13","2020-01-13","2022-03-04","2022-02-08","2021-01-27","2022-02-08","2020-01-30","2020-01-30","2020-01-30","2021-03-08","2022-03-28","2020-11-10","2021-06-16","2020-01-30","2020-01-30","2020-01-30","2021-05-29","2021-02-01","2021-04-04","2021-02-01","2021-05-29","2021-06-16","2021-06-16","2021-02-26","2021-11-23","2020-02-13","2020-02-13","2022-02-08","2021-08-25","2021-03-08","2021-03-08","2021-03-08","2020-03-16","2020-05-20","2021-11-19","2020-05-20","2020-05-20","2021-04-04","2021-04-08","2021-04-12","2021-10-29","2021-04-12","2021-04-12","2021-05-07","2021-09-27","2021-05-07","2021-05-07","2021-05-28","2021-06-16","2020-06-17","2021-07-02","2021-07-12","2021-07-14","2021-07-14","2021-07-14","2022-03-04","2022-03-04","2021-08-02","2021-08-10","2021-08-10","2021-08-16","2021-08-18","2021-11-19","2021-09-27","2021-11-23","2020-10-01","2020-10-01","2020-10-01","2019-12-06","2019-10-09","2021-11-23","2021-11-18","2019-10-24","2019-10-24","2019-12-06","2021-10-29","2021-10-29","2019-11-03","2019-11-03","2020-11-06","2020-11-06","2019-11-11","2019-11-18","2021-11-19","2019-11-21","2022-02-08","2022-02-08","2019-12-11","2022-02-08","2022-02-08","2022-02-08","2022-03-28","2022-03-04"],"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":[["","00781150610","ATENOLOL","TAB 50MG","90.00","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","20.00","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90.00","Select","Select",""],["","00093720298","PRAVASTATIN","TAB 40MG","90.00","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","30.00","Select","Select",""],["","24208048510","DORZOLAMIDE","SOL 2% OP","30.00","Select","Select",""],["","24208041105","BRIMONIDINE","SOL 0.2% OP","15.00","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","180.00","Select","Select",""],["","61314022705","TIMOLOL","SOL 0.5% OP","15.00","Select","Select",""],["","60505384901","CELECOXIB","CAP 200MG","30.00","Select","Select",""],["","68382097001","CHLORTHALID","TAB 25MG","90.00","Select","Select",""],["","57237023305","SMZ-TMP","TAB 800-160","14.00","Select","Select",""],["","00245531911","KLOR-CON","TAB 20MEQ ER","5.00","Select","Select",""],["","70710121005","ALLOPURINOL","TAB 300MG","90.00","Select","Select",""],["","55111068405","IBU","TAB 800MG","60.00","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","14.00","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21.00","Select","Select",""],["","70461012003","FLUAD","INJ 0.5ML","0.50","Select","Select",""],["","31722054301","INDOMETHACIN","CAP 50MG","30.00","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100.00","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30.00","Select","Select",""],["","49281012165","FLUZONE","INJ 2021-22","0.70","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","30.00","Select","Select",""],["","57237004105","PENICILLN","TAB 500MG","28.00","Select","Select",""],["","68462047201","POT  CL MICRO","TAB 20MEQ ER","30.00","Select","Select",""],["","00143301801","COLCHICINE","CAP 0.6MG","90.00","Select","Select",""],["","00378247401","DICLOFEN","TAB 50MG","30.00","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20.00","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","14.00","Select","Select",""],["","60505014102","GLIPIZIDE","TAB 5MG","60.00","Select","Select",""],["","51224010750","METFORMIN","TAB 750MG ER","30.00","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":""}]}]}