{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"P EIGGAMRENLLIM ","gend":1,"add":"        .RD DOOWLADIRB 44                         ","city":"PALMYRA                  ","state":"VA","zip":"22963-9998","dob":"1980-05-03","age":"","mstatus":"","insh":"00115685","cliId":"","pno":"9340870783","cno":"","email":"","ename":"","eno":"","pphy":"VARNEY, CATHERINE W","ppno":4342439466,"pcpadd":"1015 SPRING CREEK PKWY,","pcpcity":"Zion Crossroads","pcpstate":"VA","pcpzip":229427019,"pcpcounty":"","pcpid":"","pcpname":"UVA PRIMARY AND SPECIALITY CARE ZIONS CROSS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"44 BRIDALWOOD DR.                                 ","madd2":"                                                  ","madd3":"","mcity":"PALMYRA                  ","mstate":"VA","mzip":"22963-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z71.3","Z98.84","Z68.42","G93.2","F33.1","E66.01","M79.7","Z79.02","Z79.82","Z86.718","Z88.0","Z98.891","I10","M19.012","R94.31","Z45.41","F41.9","F32.9","F41.0","K21.9","G44.229","N20.0","M53.3","G89.29","G43.709","M62.838","R11.0","G08","M54.2","M54.81","M54.14","M99.02","M62.830","G44.89","M54.17","M51.27","M48.07","M51.37","M47.817","Z98.2","T82.855A","R53.83","D72.829","R25.2","R51","G47.10","R06.83","Z79.899","R10.11","Z79.01","M99.00","M53.0","M99.01","M53.1","K76.0","R51.9","H57.11","M79.89","L29.9","T50.B95A","Z82.49","Z80.0","Z88.5","Z88.1","Z88.2","R22.31","T50.Z95A","T88.1XXA","Z00.00","R73.09","Z13.220","Z68.41","Z01.818","K31.89","E28.2","Z97.5","Z83.3","K31.9","M50.20","R73.9","R53.1","E11.65","H47.10","E11.9","H52.03","H52.203","Z86.69","E11.69","E78.5","E55.9","Z79.4","G43.909","F54","K30","F51.04","F33.9","M46.1","M54.5","I36.1","E13.69","G43.719","R04.2","R05","J21.9","J45.901","K31.84","K21.00","R10.9","W19.XXXA","M47.26","M54.41","M54.42","M51.36","M48.061","M79.18","M54.12","M48.02","R20.0","R20.2","R29.898","G47.09","G47.19","M50.123","M25.562","Z01.810","Z53.8","M50.30","M47.812","Z86.2","N30.01","M77.11","F32.A","M77.12","R31.9","Z87.440","E66.9","M25.572","Z12.31","R10.2","Z01.419","R07.81","M94.0","G44.86","N20.1","N13.2","A41.9","R10.32","N13.6","N17.9","M51.9","N39.0","Z68.36","Z98.890"," "],"date":["2020-12-30","2020-06-17","2020-11-23","2022-09-19","2020-12-23","2022-09-23","2022-09-23","2021-10-15","2022-09-05","2021-10-15","2022-09-23","2019-06-19","2022-09-23","2022-02-28","2019-06-19","2019-06-19","2022-02-28","2021-08-24","2021-07-12","2021-02-08","2021-08-24","2022-09-07","2019-08-19","2022-09-05","2022-09-29","2022-02-08","2021-01-11","2022-02-28","2022-08-16","2022-02-08","2020-08-12","2020-08-12","2020-08-12","2019-08-16","2020-08-27","2020-08-27","2020-08-27","2020-08-27","2020-08-27","2022-09-19","2019-08-28","2019-08-30","2019-08-30","2019-08-30","2019-11-11","2020-09-05","2020-09-22","2022-09-23","2020-10-02","2020-10-27","2021-11-08","2021-11-08","2021-11-08","2021-11-08","2020-10-02","2020-10-05","2020-10-05","2021-10-15","2021-10-15","2021-10-15","2022-01-31","2021-10-15","2022-09-23","2021-10-15","2022-09-23","2021-10-15","2021-10-15","2021-10-15","2019-10-18","2020-01-27","2019-10-18","2021-02-22","2020-10-30","2020-10-30","2022-09-23","2022-05-05","2020-10-27","2020-10-30","2021-05-20","2020-11-06","2019-11-11","2021-05-17","2020-11-20","2022-09-23","2020-11-20","2020-11-20","2020-11-20","2022-06-06","2022-06-06","2022-06-06","2022-09-23","2022-09-05","2021-01-04","2021-01-11","2019-01-17","2019-01-17","2019-03-25","2019-03-25","2022-01-31","2021-02-08","2022-09-29","2019-02-12","2019-02-12","2019-02-12","2019-02-12","2021-03-19","2021-02-22","2022-09-05","2021-02-22","2020-03-03","2020-03-03","2020-03-03","2020-03-26","2020-03-26","2020-03-26","2021-05-20","2021-05-20","2020-03-03","2020-03-03","2020-03-03","2019-03-08","2019-03-08","2020-03-24","2021-05-03","2022-09-23","2019-05-15","2021-05-20","2021-05-20","2019-06-14","2022-09-05","2022-02-28","2022-09-23","2022-02-28","2022-03-19","2022-09-23","2022-09-23","2022-04-16","2022-05-05","2022-05-05","2022-05-05","2022-06-13","2022-06-13","2022-08-16","2022-10-12","2022-09-05","2022-09-05","2022-09-05","2022-09-05","2022-09-07","2022-09-05","2022-09-23","2022-09-23","2022-09-23","2022-10-12"],"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":[["","65862052305","GABAPENTIN","TAB 600MG","270","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","65162052111","PROMETHAZINE","TAB 25MG","90","Select","Select",""],["","68001036206","CEFDINIR","CAP 300MG","24","Select","Select",""],["","51672402301","ACETAZOLAMID","TAB 250MG","540","Select","Select",""],["","65162062750","TRAMADOL","TAB 50MG","90","Select","Select",""],["","00143973910","PREDNISONE","TAB 10MG","20","Select","Select",""],["","72618300002","NURTEC","TAB 75MG ODT","8","Select","Select",""],["","68180051703","LISINOPRIL","TAB 40MG","90","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","10","Select","Select",""],["","13668001105","CITALOPRAM","TAB 40MG","90","Select","Select",""],["","16714073201","CELECOXIB","CAP 100MG","120","Select","Select",""],["","60505025103","TIZANIDINE","TAB 2MG","90","Select","Select",""],["","80777027310","MODERNA","INJ COVID-19","0.25","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","00406012310","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","68001042300","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","3","Select","Select",""],["","52268001201","SUPREP","SOL PREP KIT","354","Select","Select",""],["","72205001290","PREGABALIN","CAP 50MG","180","Select","Select",""],["","60505257908","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","00603548321","PROPRANOLOL","TAB 20MG","180","Select","Select",""],["","42806016005","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","57515009315","INSULIN","MIS 1ML\/30G","100","Select","Select",""],["","50228010710","METFORMIN","TAB 1000MG","180","Select","Select",""],["","53885065701","ONETOUCH","KIT VERIO","1","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","50111043401","TRAZODONE","TAB 100MG","90","Select","Select",""],["","21922000909","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","99073070805","FREESTYLE    KIT LITE","KIT LITE","1","Select","Select",""],["","42167000552","LANCETS","MIS 28G","300","Select","Select",""],["","56151014260","TRUPLUS","MIS 28G","300","Select","Select",""],["","49281012165","FLUZONE","INJ 2021-22","0.7","Select","Select",""],["","08496310101","EASY","MIS 31GX3\/16","100","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","2","Select","Select",""],["","00025152031","CELEBREX","CAP 100MG","180","Select","Select",""],["","00071101268","LYRICA","CAP 25MG","60","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","42","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","55513084101","AIMOVIG","INJ 70MG\/ML","2","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":""}]}]}