{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"R MAILLIWNOSNHOJ ","gend":0,"add":"  DAOR DROF NOOCCAR 91531                         ","city":"CATALPA                  ","state":"VA","zip":"22701-9998","dob":"1951-12-15","age":"","mstatus":"","insh":"00117888","cliId":"","pno":"2804518285","cno":"","email":"","ename":"","eno":"","pphy":"KIM, JUN WOONG","ppno":5408256100,"pcpadd":"1200 SUNSET LN STE 2210,","pcpcity":"Culpeper","pcpstate":"VA","pcpzip":227013376,"pcpcounty":"","pcpid":"","pcpname":"UVA PRIMARY CARE CULPEPER FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"13519 RACCOON FORD ROAD                           ","madd2":"                                                  ","madd3":"","mcity":"CATALPA                  ","mstate":"VA","mzip":"22701-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K80.10","K80.20","K81.2","I10","E78.5","K40.90","K80.12","R10.9","J44.9","E03.9","K21.9","Z85.21","Z90.02","Z93.0","Z87.891","I25.10","Z95.1","Z95.5","K81.0","K80.70","Z90.49","E78.00","R73.09","C32.1","R10.84","R19.7","Z85.819","Z79.899","Z03.821","T85.628A","R13.19","Z93.1","Z46.59","T18.9XXA","Z01.89","J95.03","Y83.3","K22.2","R13.0","Z85.09","K57.90","Z20.822","K57.30","T17.908A","R49.1","Z43.0","J86.0","R13.10","T85.598A","K94.20","R62.7","Z43.1","K63.89","C14.0","R13.14","Z00.00","J98.2","P25.2"," ","R07.9","S11.21XA","D64.9","R74.8","L92.9","K92.2","Z85.818","A41.9","R91.8","X58.XXXA","K94.29","R07.89","R05.9","Z85.89","K22.3","J18.9","E16.2","K94.21","Z92.3","Z79.890","Z79.2"],"date":["2020-01-27","2022-05-12","2020-01-27","2022-11-11","2022-10-23","2022-05-12","2020-01-27","2020-01-27","2022-06-14","2022-11-16","2022-10-25","2022-10-23","2022-10-25","2022-10-23","2022-10-21","2020-01-27","2020-01-27","2020-01-27","2020-01-27","2020-01-26","2020-02-19","2022-11-11","2020-05-11","2022-10-03","2020-01-26","2022-10-21","2022-10-22","2022-10-22","2022-05-04","2022-05-04","2022-06-22","2022-10-21","2022-05-12","2022-05-04","2022-05-31","2022-05-04","2022-05-12","2022-10-23","2022-05-12","2022-05-12","2022-05-12","2022-10-21","2022-05-12","2022-11-03","2022-11-03","2022-11-03","2022-05-23","2022-10-03","2022-05-12","2022-10-21","2022-06-22","2022-11-07","2022-05-12","2022-05-12","2022-11-03","2022-08-30","2022-10-26","2022-10-22","2022-11-16","2022-10-22","2022-11-16","2022-11-16","2022-10-03","2022-11-07","2022-10-23","2022-10-23","2022-10-22","2022-10-25","2022-11-16","2022-10-21","2022-10-21","2022-10-21","2022-10-21","2022-10-25","2022-10-22","2022-10-22","2022-10-22","2022-10-22","2022-10-22","2022-10-22"],"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":[["","00093505998","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","72305008830","EUTHYROX","TAB 88MCG","90","Select","Select",""],["","47781064990","LEVOTHYROXIN","TAB 88MCG","90","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","52652500101","KATERZIA","SUS 1MG\/ML","300","Select","Select",""],["","50111032801","HYDRALAZINE","TAB 50MG","180","Select","Select",""],["","00000000000","URSODIOL","CAP 300MG","88","Select","Select",""],["","65862053513","AMOX\/K","SUS 600\/5ML","125","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","4","Select","Select",""],["","68645014059","FAMOTIDINE","TAB 20MG","90","Select","Select",""],["","71858012505","TIROSINT-SOL","SOL 88MCG\/ML","30","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}