{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ACCEBERDDIK L ","gend":1,"add":" 64 TPA TEERTS TUNLAW 105                         ","city":"LAWRENCEVILLE            ","state":"VA","zip":"23868-2019","dob":"1957-10-22","age":"","mstatus":"","insh":"00117053","cliId":"","pno":"3543476232","cno":"","email":"","ename":"","eno":"","pphy":"ACKERMAN, CHRISTOPHER J","ppno":4348480771,"pcpadd":"203 SHARP ST,PO BOX 459","pcpcity":"Lawrenceville","pcpstate":"VA","pcpzip":238681615,"pcpcounty":"","pcpid":"","pcpname":"LAWRENCEVILLE PRIMARY CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"57 Brunswick Commons Ct Apt C                     ","madd2":"                                                  ","madd3":"","mcity":"Lawrenceville            ","mstate":"VA","mzip":"23868-3405","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I63.9","R32","N39.46","L22","R69","J44.9","H04.123","M62.830","N39.0","M19.90","M62.81","J44.1","H90.6","H74.03","J44.0","J40","J84.10","S22.49XD","I10","F32.9","E46","F17.210","Z79.2","Z99.81","Z91.81","Z86.73","L50.9","R05","R53.83","R21","R10.9","E78.00","R19.5","R35.0","J96.01","J96.10","J15.9","S22.42XA","I46.9","J96.21","J18.9","E44.0","E87.2","J20.9","M62.569","E87.5","I95.9","Y84.8","R07.81","J98.11","F41.9","E83.52","R07.9","F33.9","K21.9","R10.811","R10.2","D50.9","N39.9","M47.812","R10.84","J96.11","R11.2","R42","R53.1","R68.83","R61","R39.81","Z11.59","Z12.11","R91.8","R07.89","H90.71","K52.9","R10.31","R10.32","R51","R20.2","H53.9","I11.9","E03.9","M79.10","R06.02","R06.2","M54.9","H66.93","I49.9","E78.5","R03.1","R30.0","N64.4","E22.1","M15.9","S22.32XA","R06.89","Z74.3","I69.351","R41.0","M51.37","Z12.31","H60.93","Z79.899","Z88.1","Z88.5","Z88.0","Z88.2","Z88.7","A41.9","D64.9","E11.9"," "],"date":["2022-12-01","2019-09-30","2022-11-21","2022-11-21","2021-08-01","2022-11-21","2018-08-07","2019-08-15","2020-01-20","2019-08-15","2022-05-02","2022-06-03","2021-12-14","2021-12-14","2018-12-18","2018-12-18","2021-03-25","2018-12-18","2022-09-15","2018-12-18","2018-12-18","2020-10-29","2018-12-18","2020-10-29","2018-12-18","2020-10-29","2018-12-20","2021-03-16","2018-12-20","2022-06-03","2020-06-30","2022-09-15","2019-07-29","2019-07-29","2018-11-18","2021-03-25","2018-11-26","2018-11-19","2018-11-25","2018-11-19","2018-11-19","2018-11-19","2018-11-19","2018-11-25","2018-11-19","2018-11-19","2018-11-19","2018-11-19","2018-11-19","2018-11-25","2018-11-25","2018-11-25","2021-03-16","2018-11-25","2021-03-09","2020-02-03","2019-08-23","2021-03-09","2020-01-20","2021-03-09","2020-07-01","2020-09-10","2018-10-08","2020-01-20","2018-10-08","2018-10-08","2018-10-08","2018-10-08","2020-10-27","2020-10-29","2018-11-17","2018-12-11","2021-12-14","2021-03-16","2021-03-16","2021-03-16","2019-08-15","2019-08-15","2019-08-15","2020-09-29","2022-05-26","2018-11-17","2020-07-01","2018-11-17","2018-11-17","2022-02-15","2021-03-09","2021-03-25","2021-03-16","2019-05-10","2018-06-27","2018-06-27","2018-09-25","2018-11-19","2018-12-19","2018-12-19","2021-03-25","2020-07-01","2019-08-15","2018-08-14","2021-10-25","2021-10-25","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2022-05-26","2022-09-15","2022-05-26","2022-12-01"],"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":[["","00597008717","ATROVENT","AER 17MCG","25.8","Select","Select",""],["","68382005101","MELOXICAM","TAB 15MG","30","Select","Select",""],["","52817032010","BACLOFEN","TAB 10MG","60","Select","Select",""],["","76204020025","ALBUTEROL","NEB 0.00083","300","Select","Select",""],["","70954031610","FAMOTIDINE","SUS 40MG\/5ML","150","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","68382018201","BUSPIRONE","TAB 15MG","60","Select","Select",""],["","60505257909","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","00121086816","NYSTATIN","SUS 100000","120","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22.00","Select","Select",""],["","31722077701","ACYCLOVIR","TAB 400MG","42","Select","Select",""],["","65162044110","MECLIZINE","TAB 12.5MG","60","Select","Select",""],["","24208063562","NEO\/POLY\/HC","SUS 1% OTIC","10","Select","Select",""],["","00168000380","TRIAMCINOLON","CRE 0.00025","80","Select","Select",""],["","00527058601","DICYCLOMINE","CAP 10MG","20","Select","Select",""],["","68382055901","NITROFUR","CAP 50MG","14","Select","Select",""],["","00143992701","CIPROFLOXACN","TAB 250MG","14","Select","Select",""],["","00591505201","PREDNISONE","TAB 5MG","16","Select","Select",""],["","60758018805","GENTAMICIN","SOL 0.3% OP","15","Select","Select",""],["","29300022701","METRONIDAZOL","TAB 500MG","21","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","7","Select","Select",""],["","68462029817","CLOTRIM\/BETA","CRE DIPROP","15","Select","Select",""],["","00378797052","IPRATROPIUM","SOL 0.02%INH","62.5","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","16714039102","CEFDINIR","CAP 300MG","13","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":""}]}]}