{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"V A ECYORENITNELA","gend":0,"add":"AICEPS 4 ERAC LAICEPS O\/C                    LPP L","city":"RICHMOND                 ","state":"VA","zip":"23227-5875","dob":"1972-08-23","age":"","mstatus":"","insh":"00117930","cliId":"","pno":"6240842851","cno":"","email":"","ename":"","eno":"","pphy":"MOORE, WILLIAM","ppno":8042649185,"pcpadd":"2400 E PARHAM RD,","pcpcity":"Henrico","pcpstate":"VA","pcpzip":232283119,"pcpcounty":"","pcpid":"","pcpname":"PARHAM HEALTHCARE & REHAB CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"P.O. BOX 15875                                    ","add3":"","madd1":"C\/O SPECIAL CARE 4 SPECIAL PPL                    ","madd2":"P.O. BOX 15875                                    ","madd3":"","mcity":"RICHMOND                 ","mstate":"VA","mzip":"23227-5875","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R55","N17.9","W19.XXXA","I95.9","E87.2","Z79.899","F20.9","I15.2","E55.9","M10.9","A41.9","R65.21","G93.40","F10.10","F17.200","F25.9","F31.9","J10.1","N18.3","R00.0","R10.9","R29.700","R40.2412","R40.2362","R40.2142","R94.31","N18.4","N25.1","R42","L97.511","E11.9","Z71.3","Z23","Z12.11","I10","E78.5","M79.674","B35.1","M79.675","F20.0","E11.69","J20.9","N28.9","I95.1","J11.1","T56.891A","N18.30","T56.891D","Z76.89","R94.4","D72.829","R41.82","Z04.3","Z00.00","F17.210","E86.0","K08.9","T43.591A","T43.595A","Z20.822","E11.22","I12.9","Z79.82","Z79.84","Z11.1","L60.0","I07.1","Z71.89","F17.290","Z11.59","Z11.4","R06.2","Y92.89","Y93.89","M20.41","N18.31","Z02.89","N39.44","R74.8","B35.3","L30.9","L60.9","D23.71","D23.72","R74.01","D64.9","Z72.0"," ","R73.03"],"date":["2019-03-07","2021-09-07","2019-01-24","2021-10-19","2019-04-10","2022-10-17","2022-08-09","2022-05-17","2022-10-17","2022-05-17","2019-04-12","2019-04-15","2019-04-10","2019-04-10","2022-06-07","2019-04-10","2021-08-30","2019-04-15","2020-09-18","2019-04-10","2019-04-15","2019-04-10","2019-04-10","2019-04-10","2019-04-10","2019-04-10","2022-08-09","2022-08-09","2021-08-30","2021-10-08","2021-10-08","2020-10-15","2022-11-08","2022-12-02","2022-10-17","2022-10-17","2022-09-12","2022-09-12","2022-09-12","2022-10-17","2022-10-17","2019-01-28","2019-05-15","2019-03-07","2019-04-12","2021-09-01","2022-11-08","2021-09-07","2021-09-07","2021-09-07","2021-08-30","2021-08-30","2019-01-23","2021-08-03","2022-05-17","2019-03-06","2021-08-03","2021-08-30","2021-08-30","2022-07-21","2021-08-30","2021-08-30","2021-08-30","2021-08-30","2021-10-19","2020-10-27","2019-03-07","2019-07-24","2019-07-24","2022-06-07","2022-06-07","2021-10-19","2019-01-23","2019-01-23","2021-04-08","2021-09-21","2021-09-21","2022-11-08","2022-05-02","2022-04-21","2022-04-21","2022-04-21","2022-09-12","2022-09-12","2022-06-07","2022-07-12","2022-09-20","2022-12-02","2022-11-08"],"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":[["","00378082501","CLOZAPINE","TAB 25MG","28","Select","Select",""],["","43547035211","LISINOPRIL","TAB 5MG","31","Select","Select",""],["","00378306677","FENOFIBRATE","TAB 145MG","31","Select","Select",""],["","54838050140","HALOPERIDOL","CON 2MG\/ML","30","Select","Select",""],["","00054002125","LITHIUM","TAB 300MG ER","62","Select","Select",""],["","59762490004","SERTRALINE","TAB 50MG","31","Select","Select",""],["","00781538492","ATORVASTATIN","TAB 40MG","31","Select","Select",""],["","68382009201","CARVEDILOL","TAB 3.125MG","62","Select","Select",""],["","62756016013","TAMSULOSIN","CAP 0.4MG","24","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","00378013701","ALLOPURINOL","TAB 100MG","62","Select","Select",""],["","68382003005","METFORMIN","TAB 1000MG","62","Select","Select",""],["","68180016006","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59746017306","PREDNISONE","TAB 10MG","6","Select","Select",""],["","58160089652","FLUARIX","INJ 2019-20","0.5","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}