{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AZ AREVYKSLEV","gend":1,"add":"     RD KRAP YROKCIH 1005                         ","city":"GLEN ALLEN               ","state":"VA","zip":"23059-9998","dob":"1934-02-15","age":"","mstatus":"","insh":"00116728","cliId":"","pno":"8640809623","cno":8043462112,"email":"","ename":"","eno":"","pphy":"VEDINA, ANNA","ppno":8047452200,"pcpadd":"13440 TREDEGAR LAKE PKWY,  BLDG 2","pcpcity":"Midlothian","pcpstate":"VA","pcpzip":231124070,"pcpcounty":"","pcpid":"","pcpname":"JAMES RIVER INTERNISTS INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"5001 HICKORY PARK DR                              ","madd2":"APT 134                                           ","madd3":"","mcity":"GLEN ALLEN               ","mstate":"VA","mzip":"23059-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R39.81","L03.116","M81.0","Z85.3","F41.9","I89.0","I10","D04.5","Z90.12","D48.9","H40.1433","H35.3130","H18.59","Z96.1","R35.0","H35.30","R35.1","R73.03","E78.5","N39.0","Z23","L82.1","F51.01","F41.8","N64.4","R07.9","M79.602","R39.15","C44.329","H52.7","K59.01","Z13.220","Z13.1","R42","R60.9","N89.8","R55","M17.10","Z01.818","Z87.440","L82.0"],"date":["2022-07-21","2019-09-26","2019-09-26","2019-09-26","2020-05-29","2022-06-01","2022-07-21","2020-08-27","2019-12-29","2020-08-27","2022-05-16","2021-10-04","2020-09-11","2022-05-16","2020-05-29","2022-05-02","2022-03-16","2019-11-05","2019-11-05","2019-11-05","2019-10-29","2020-08-27","2021-02-12","2022-03-16","2020-05-29","2020-05-29","2020-05-29","2020-05-29","2020-10-22","2021-10-04","2022-03-16","2022-03-16","2022-03-16","2022-03-16","2019-09-04","2019-09-04","2019-09-04","2019-09-04","2020-10-20","2020-08-06","2020-08-06"],"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":[["","00093001006","TOLTERODINE","TAB 1MG","60","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","90","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","180","Select","Select",""],["","24208046325","LATANOPROST","SOL 0.00005","7.5","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","90","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","24208048510","DORZOLAMIDE","SOL 2% OP","10","Select","Select",""],["","00023921105","COMBIGAN","SOL 0.2\/0.5%","15","Select","Select",""],["","00456120330","LINZESS","CAP 72MCG","30","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","20","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","49884072501","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","14539067501","HYDROXYZ","CAP 50MG","90","Select","Select",""],["","00378479106","FLUOROURACIL","CRE 0.05","40","Select","Select",""],["","69097015807","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","00228202750","ALPRAZOLAM","TAB 0.25MG","60","Select","Select",""],["","51672404801","CLOTRIM\/BETA","CRE DIPROP","60","Select","Select",""],["","49281012065","FLUZONE","INJ PF 20-21","0.7","Select","Select",""],["","68180030360","CEFUROXIME","TAB 500MG","10","Select","Select",""],["","70461012103","FLUAD","INJ 2021-22","0.5","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":""}]}]}