{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" L TREBORRJ YDEEWT","gend":0,"add":"     EUNEVA ANILORAC 1013                         ","city":"RICHMOND                 ","state":"VA","zip":"23222-3205","dob":"1935-07-17","age":"","mstatus":"","insh":"00117928","cliId":"","pno":"9540830551","cno":"","email":"","ename":"","eno":"","pphy":"MAUGHAN, GEORGE T","ppno":8048223480,"pcpadd":"110 N ROBINSON ST STE 400,","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232204462,"pcpcounty":"","pcpid":"","pcpname":"RETREAT INTERNAL MEDICINE  LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"3101 CAROLINA AVENUE                              ","madd2":"                                                  ","madd3":"","mcity":"RICHMOND                 ","mstate":"VA","mzip":"23222-3205","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K40.20","K41.90","K40.90","I25.10","Z87.891","Z79.82","R10.9","R93.89","R93.5","R14.0","I71.4","R60.1","R91.8","Z98.890","I10","N17.9","R10.31","R94.31","U07.1","Z48.815","J96.01","K21.9","R06.02","M79.10","R09.02","J12.82","E44.0","R64","D64.9","Z66","Z79.899","Z79.4","I71.01","R06.00","F17.210","M10.9","R29.898","A41.9","J18.9","J96.21","J96.22","E43","E87.2","J84.9","Z68.1","Z51.5","Z20.822","R65.20","R54","Z87.01","Z86.16","Z86.79","I35.1","I36.1","I34.8","R52","M54.9","R07.9","R53.83","Z71.89","M19.90","N40.0","K27.9","E55.9","M54.5","R63.4","J98.11","J98.4","K30","G89.29","K46.9","K40.30","K56.609","M51.36","M47.816","M51.37","M47.817","Z95.828","M54.50","Z00.00","K64.1","D50.0","M17.11","J40","Z91.81","Z11.59","R10.30","Z79.891","L76.34","D62","R10.32","E86.0","Z87.11","N28.9","T81.31XA"," "],"date":["2022-01-13","2022-01-07","2022-01-10","2022-01-04","2022-01-04","2022-01-04","2022-01-07","2022-01-06","2022-01-06","2022-01-06","2022-01-06","2022-01-06","2022-01-06","2022-01-06","2022-10-21","2022-01-08","2022-01-10","2022-01-07","2022-06-22","2022-01-13","2021-04-06","2021-01-27","2021-04-05","2021-01-22","2021-05-18","2021-01-22","2021-01-22","2021-01-22","2021-01-22","2022-01-07","2022-01-07","2021-01-22","2021-04-06","2020-11-05","2020-11-05","2022-06-22","2022-05-24","2021-04-06","2021-06-15","2021-04-03","2021-04-03","2021-04-03","2021-04-03","2022-06-22","2021-04-03","2021-04-05","2021-04-03","2021-04-03","2021-04-05","2021-04-03","2022-01-07","2021-04-03","2021-04-03","2021-04-03","2021-04-03","2021-04-03","2021-04-06","2021-04-06","2021-04-05","2021-04-05","2021-04-21","2021-07-14","2022-05-24","2021-04-21","2021-07-14","2021-11-17","2021-06-14","2021-05-27","2021-07-14","2021-07-14","2021-09-03","2022-01-07","2021-09-23","2020-11-02","2020-11-02","2020-11-02","2020-11-02","2020-11-02","2022-01-07","2022-06-22","2022-05-24","2020-11-18","2019-11-27","2019-12-16","2019-11-27","2021-12-31","2022-01-06","2022-01-13","2022-01-07","2022-01-07","2022-01-07","2022-01-07","2022-01-07","2022-05-24","2022-02-01","2022-10-21"],"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":[["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","60","Select","Select",""],["","68645049659","CARVEDILOL","TAB 25MG","90","Select","Select",""],["","68180097903","LISINOPRIL","TAB 40MG","90","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","15.00","Select","Select",""],["","29300035505","TRAMADOL","TAB 50MG","31","Select","Select",""],["","00054418625","DEXAMETHASON","TAB 6MG","3","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","00003089321","ELIQUIS","TAB 2.5MG","28","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","28","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","20","Select","Select",""],["","00527293337","PREDNISONE","TAB 10MG","30","Select","Select",""],["","49281012065","FLUZONE","INJ PF 20-21","0.7","Select","Select",""],["","61442010305","DICLOFENAC","TAB 75MG DR","180","Select","Select",""],["","00254200801","COLCHICINE","TAB 0.6MG","3","Select","Select",""],["","65862064163","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","55111013001","RANITIDINE","CAP 300MG","90","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":""}]}]}