{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ECILAEROOM","gend":1,"add":"    ,ECARRET GNILLOB 8072                         ","city":"RICHMOND                 ","state":"VA","zip":"23223-9998","dob":"1946-12-13","age":"","mstatus":"","insh":"00115227","cliId":"","pno":"0240868733","cno":8048822333,"email":"","ename":"","eno":"","pphy":"WHITE, KELLEY ELIZABETH","ppno":8042827857,"pcpadd":"7001 FOREST AVE STE 2500,STE 2500","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232301726,"pcpcounty":"","pcpid":"","pcpname":"WEST END INTERNAL MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"2708 BOLLING TERRACE,                             ","madd2":"                                                  ","madd3":"","mcity":"RICHMOND                 ","mstate":"VA","mzip":"23223-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R39.81","I10","I69.854","Z68.28","I69.898","R26.81","R29.898","Z00.00","E11.9","Z68.29","I67.9","G40.909","E78.5","J18.9","J45.20","G81.14","R69","I63.9","R56.9","Z79.82","Z87.891","J45.909","Z86.73","M19.90","Z97.2","I69.354","N39.46","L30.9","J18.1","R93.89","R91.8","L72.3","E11.40","I69.998","R42","M25.512","M25.532","M25.362","I27.81","I69.30","I27.82","Z51.81","R73.09","M21.372","Z20.822","E66.3","Z13.39","Z13.31","Z12.31","Z12.11","Z23","E87.6","I51.7","R94.31","I44.0","R94.39","I21.A1","J45.21","I11.9","Z86.711","Z88.0","Z88.8","R05.9","J98.09","R77.8","J45.901","J12.89","J98.4","R07.89","D12.3","Z80.0","K63.5","I11.0","I50.9","Z87.442","E78.00","Z79.899","Z82.49","Z82.3","Z79.01","M06.9","E11.21"," ","R03.0"],"date":["2022-11-23","2022-07-08","2020-05-08","2020-01-20","2020-01-14","2020-03-03","2020-03-03","2022-01-14","2022-01-18","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-01-18","2022-07-08","2022-07-08","2020-04-15","2022-11-08","2022-11-08","2020-01-20","2021-10-14","2020-01-20","2020-03-03","2020-01-20","2020-01-20","2021-10-14","2020-01-20","2020-01-20","2022-01-27","2022-01-27","2022-01-27","2022-02-04","2022-02-04","2020-03-03","2020-03-03","2020-03-03","2020-03-03","2020-03-03","2019-05-02","2019-12-13","2019-12-13","2019-12-13","2020-12-09","2021-05-10","2021-10-14","2019-09-13","2019-09-13","2019-09-13","2022-05-02","2019-12-10","2021-10-01","2021-10-01","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-15","2021-11-23","2021-10-16","2019-12-10","2019-12-10","2019-12-10","2021-08-12","2021-08-12","2019-12-10","2019-12-10","2019-12-10","2019-12-10","2019-12-10","2019-12-13","2021-08-12","2022-07-08","2022-11-23","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":[["","70377003012","ATORVASTATIN","TAB 80MG","90","Select","Select",""],["","00085433301","ASMANEX","AER 100 MCG","39","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10.2","Select","Select",""],["","57664050658","METOPROL","TAB 25MG","180","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","90","Select","Select",""],["","55111053301","DIVALPROEX","TAB 250MG ER","90","Select","Select",""],["","65162083809","VALSARTAN","TAB 80MG","90","Select","Select",""],["","24658031205","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","00378967130","IPRATROPIUM\/","SOL ALBUTER","90","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","51672404801","CLOTRIM\/BETA","CRE DIPROP","30","Select","Select",""],["","23155013525","DOXYCYC","TAB 100MG","20","Select","Select",""],["","58160081912","SHINGRIX","INJ 50MCG","1","Select","Select",""],["","43386006019","GAVILYTE-C","SOL ","4,000.00","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","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":["",""],"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":""}]}]}