{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ECIRALCNOSIRRAH","gend":1,"add":"TSSALG TSAE 0165 TPA ,EVA ENO","city":"RICHMOND","state":"VA","zip":23223,"dob":"1963-11-12","age":"","mstatus":"","insh":"00118542","cliId":"","pno":"2540857722","cno":"","email":"","ename":"","eno":"","pphy":"PINSON, ANDY G","ppno":8045222775,"pcpadd":"1201 E MARSHALL ST,","pcpcity":"RICHMOND","pcpstate":"VA","pcpzip":23298,"pcpcounty":"","pcpid":"","pcpname":"VCUHS AD WILLIAMS CLINIC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"Central","aligned":"Y","ano":"","add2":"APT 5","add3":"","madd1":"6801 W Carnation St Apt G","madd2":"","madd3":"","mcity":"Richmond","mstate":"VA","mzip":"23225-5254","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R59.0","M54.12","M62.838","M54.5","M79.606","R07.9","M79.604","M79.605","I10","F11.20","T84.018A","M17.11","Z96.659","J45.909","F17.210","M47.816","M79.18","Z96.89","G89.29","T85.112A","T85.113A","M54.50","Z45.42","E63.9","E11.9","N31.2","G47.33","F41.9","B20","F32.A","E27.40","R94.4","Z79.52","R60.0","Z87.448","Z79.899","R49.0","J38.7","K21.9","F32.9","E10.9","Z87.891","J45.901","E66.9","F64.9","M43.06","M47.817","M54.16","Z21","E11.22","N18.2","Z79.84","M54.10","Z86.2","A60.9","F34.1","R06.02","R07.89","Z79.82","F31.0","F14.20","F90.2","Z12.31","M46.1","Y79.2","M25.761","T84.092A","E78.5","E27.9","Z79.51","Z79.1","Z01.810","A41.9","N39.0","R50.9","R11.0","R35.0","G89.18","T84.012A","Z96.641","M54.9","T84.022D","Z96.651","Z79.891","G83.12","R25.2","M51.26","M48.061","M54.89","R53.1","Z46.2","J98.11","Z97.8","M51.36","M24.19","Z96.82","F31.32","M77.51","R73.03","R22.1","N95.1","Z01.812","R06.00","Z11.59","M47.814","M96.1","M72.9","G89.4","M47.26","F43.10","Z79.4","Z88.5","Z90.79","M25.561","Z47.1","H25.813","J20.9","A53.9","F64.0","S60.032A","M79.645","W26.8XXA","B19.20","F17.290","W29.4XXA","S69.92XA","R11.2","R11.10","E86.0","R10.13","Z79.890","R06.09","S93.402A","X50.1XXA","Y92.480","M11.261","M16.11","M25.551","S76.211A","S83.91XA","F64.8","F31.31","R10.9","R19.7","F17.200","R10.84","K57.30","K44.9","Y83.1","K59.00","I49.1","K42.9","K43.9","M51.34","M79.89","Z98.1","M20.11","M19.071","M72.2","K62.89","A60.1","F45.8","B02.9","R10.30","M67.971","M79.671","M25.571","H11.32","H57.89","R05","S86.011A","Z45.89","X58.XXXA","Y92.9","Y93.9","G47.30","N18.3","Z72.0","F12.90","R10.11","M54.2","N31.9","M21.372","R51","R32","R15.9","R18.8","M25.78","R33.9","Z11.3","Z87.890","J39.8","Z91.19","Z98.890","R91.8","M19.072","M21.962","M21.42","M77.32","R52","S82.202A","Z51.81","Z46.89","M25.572","Z47.89","M79.652","M47.815","M16.0","R06.83","Z96.29","R10.10","K57.92","Z87.19","J40","R20.0","R06.4","M20.62","M84.378A","Z48.813","M19.012","S82.202D","I70.229","Z03.89","M20.60","R51.9","S90.411A","S99.921A","M20.5X2","Z68.30","Z23","K29.70","E55.9","R10.32","M47.27","M79.1","Z09","N18.30","R06.2","R53.83","E11.65","R73.9","R48.0","M48.00","J30.9","H28","E11.36","Z68.27","B18.2","M17.9","M25.50","Z99.89","R13.13","K66.0","J45.21","J06.9","R13.10","Z96.9","R10.31","Z12.11","Z86.010","Z48.815","R63.1","E16.2","K43.2","R93.5","F33.1","N63.0","N64.4","W00.0XXA","S76.111A","E11.40","M19.90","S83.101A","M25.461","S86.911A","R07.2","E87.2","E27.3","Z66","F14.10","K76.0","E88.1","J69.0","H66.91","H92.01","R09.81","E74.39","H01.004","H57.9","H01.001","H10.33","M25.661","M62.81","H10.213","M25.519","R73.09","Z01.818","R13.14","D12.0","D12.5","K64.8","M76.62","M79.672","R00.0","J09.X2","M21.41","M21.271","M77.31","M76.61","B96.81"," ","J45.20","K46.9","M79.674","H60.92","M54.42","M79.641","M79.642","Z13.228","H52.203","H52.4","H05.20","H25.13","N39.46","R26.9","Z74.09","R53.81","E87.6","R29.898","N39.41","Z87.440","M48.02","Z78.9","K62.82","M79.2","I87.2","I65.29","E11.69","M99.73","R09.89","R05.9","Z20.822","F41.8","R10.33","R69","R94.31","H92.02","H93.92","Z68.29","M50.30","Z04.9","S93.504A","D01.3","E11.8","R85.69","R85.610","M19.042","M19.041","M54.32","A63.0","N18.9","M25.612","R29.3"],"date":["2022-10-27","2018-11-29","2021-07-29","2021-07-19","2019-01-29","2022-11-22","2022-12-06","2021-08-08","2022-11-28","2021-03-01","2022-01-13","2021-12-28","2022-01-13","2022-11-22","2022-11-18","2022-07-26","2018-12-04","2019-02-03","2022-11-18","2018-12-04","2019-04-15","2022-11-06","2021-12-06","2022-11-18","2022-11-22","2021-12-06","2022-11-18","2022-11-18","2022-10-27","2022-11-18","2022-11-18","2021-12-06","2021-12-06","2020-12-07","2020-12-07","2022-01-16","2021-09-27","2020-12-07","2022-11-22","2021-09-03","2020-12-07","2021-12-20","2022-09-20","2018-12-10","2021-05-14","2021-12-10","2022-11-10","2022-11-10","2022-07-13","2022-11-18","2021-12-10","2022-11-22","2021-12-10","2021-12-10","2021-12-10","2020-12-11","2022-09-20","2018-12-14","2022-11-22","2018-12-18","2020-11-02","2021-06-28","2021-11-16","2022-08-25","2021-12-20","2021-12-20","2021-12-28","2022-09-20","2021-12-20","2022-11-22","2021-12-20","2021-12-20","2021-12-25","2022-03-08","2021-12-25","2022-07-26","2022-01-16","2022-02-03","2021-12-28","2021-12-28","2022-11-30","2021-12-31","2022-01-20","2021-12-31","2018-02-16","2018-03-30","2022-11-30","2022-08-03","2018-02-17","2022-11-22","2020-07-06","2018-02-16","2018-04-18","2022-11-30","2021-02-17","2021-05-30","2020-09-26","2021-02-19","2018-02-21","2021-11-22","2018-02-21","2021-08-06","2021-06-01","2021-02-26","2018-03-01","2018-03-01","2021-03-01","2022-08-02","2022-09-08","2021-03-01","2021-08-20","2021-03-01","2021-10-29","2022-02-26","2022-02-03","2018-03-06","2019-03-08","2019-03-08","2021-05-03","2019-03-12","2019-03-12","2019-03-12","2019-03-12","2019-03-12","2019-03-12","2019-03-12","2022-11-06","2018-03-13","2022-02-23","2022-02-15","2018-03-13","2019-03-22","2018-03-21","2021-08-11","2018-03-21","2021-03-25","2021-11-19","2021-03-25","2021-03-25","2021-03-25","2018-03-30","2020-07-28","2022-10-27","2022-11-06","2022-11-06","2022-07-13","2022-02-15","2022-11-22","2019-04-15","2020-09-26","2021-08-06","2018-07-06","2021-10-29","2018-04-18","2022-02-26","2021-05-30","2021-02-09","2021-02-09","2021-02-09","2021-04-26","2021-04-26","2018-04-30","2021-04-30","2022-02-23","2020-05-08","2021-08-11","2021-02-01","2021-05-11","2021-05-11","2021-05-11","2020-05-20","2020-05-19","2022-03-18","2020-05-20","2020-05-20","2022-01-16","2020-08-21","2018-05-24","2018-06-22","2021-05-28","2022-11-22","2022-11-18","2020-05-30","2020-05-30","2022-11-06","2022-11-06","2020-05-30","2021-05-30","2021-05-31","2019-01-25","2018-06-04","2018-06-22","2018-06-22","2022-10-27","2018-06-22","2021-09-15","2021-07-04","2021-06-28","2021-09-02","2021-07-29","2021-06-28","2021-01-15","2021-07-04","2021-07-04","2021-09-02","2020-07-06","2020-07-06","2020-07-06","2020-07-07","2020-07-07","2022-07-13","2021-07-09","2021-10-08","2021-07-11","2022-11-22","2021-07-11","2021-07-27","2021-07-14","2018-07-24","2021-07-26","2021-07-26","2020-07-27","2021-07-29","2021-08-06","2021-08-08","2021-08-11","2021-08-11","2021-08-20","2021-08-20","2022-10-11","2022-08-02","2021-01-29","2022-10-27","2021-08-24","2018-08-28","2021-09-15","2021-09-03","2018-09-14","2020-09-17","2018-10-19","2018-09-24","2020-09-26","2020-09-26","2020-09-26","2020-09-26","2020-09-26","2022-03-17","2020-09-26","2020-09-26","2020-09-26","2020-09-26","2021-09-27","2018-10-05","2020-10-06","2020-10-06","2020-11-18","2020-10-06","2022-10-27","2021-10-08","2021-10-08","2021-10-08","2018-10-19","2018-10-19","2021-10-29","2021-10-29","2020-10-30","2020-11-02","2020-11-02","2021-11-06","2021-11-06","2021-11-06","2022-08-03","2021-11-06","2022-02-26","2021-11-06","2018-11-07","2018-11-07","2018-11-07","2018-11-07","2018-11-07","2018-11-07","2018-11-07","2020-11-18","2021-11-22","2021-11-22","2022-09-20","2018-01-12","2018-01-20","2018-01-20","2018-01-20","2018-01-20","2022-02-03","2022-12-07","2018-01-22","2018-01-24","2022-09-06","2022-10-11","2018-02-07","2019-02-01","2019-02-01","2019-02-01","2021-02-01","2021-02-01","2019-02-03","2019-02-03","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2022-12-07","2022-10-04","2022-04-14","2022-03-18","2022-06-25","2022-08-29","2022-04-14","2022-04-14","2022-04-14","2022-06-15","2022-06-15","2022-08-02","2022-06-15","2022-11-30","2022-11-30","2022-09-22","2022-02-23","2022-02-23","2022-11-10","2022-07-15","2022-07-15","2022-11-22","2022-06-16","2022-11-18","2022-06-29","2022-06-16","2022-06-16","2022-08-02","2022-09-08","2022-09-20","2022-09-20","2022-09-20","2022-11-18","2022-11-06","2022-11-01","2022-11-06","2022-06-25","2022-06-25","2022-06-16","2022-12-07","2022-11-22","2022-03-18","2022-05-24","2022-03-31","2021-12-10","2022-06-10","2022-04-14","2022-04-14","2022-09-27","2022-11-18","2022-11-18","2022-12-07","2022-12-07"],"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":[["","50111056001","TRAZODONE","TAB 50MG","45","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","62175061846","PANTOPRAZOLE","TAB 20MG","90","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","61958250101","BIKTARVY","TAB ","30","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","180","Select","Select",""],["","00781716783","ESTRADIOL","DIS 0.1MG","8","Select","Select",""],["","00006306901","PIFELTRO","TAB 100MG","30","Select","Select",""],["","00002143480","TRULICITY","INJ 1.5\/0.5","2","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","90","Select","Select",""],["","56151147002","TRUE","KIT METER","1","Select","Select",""],["","00093010901","CARBAMAZEPIN","TAB 200MG","7","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","20","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","00517042001","ESTRAD","INJ 20MG\/ML","5","Select","Select",""],["","70377000712","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","00093726710","METFORMIN","TAB 500MG ER","360","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","31722070530","VALACYCLOVIR","TAB 1GM","5","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","90","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","70436005901","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","47335061730","DRIZALMA","CAP 30MG DR","60","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","17","Select","Select",""],["","00173071920","FLOVENT","AER 110MCG","36","Select","Select",""],["","69584061150","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","00173085910","BREO","INH 100-25","60","Select","Select",""],["","51991074790","DULOXETINE","CAP 30MG","60","Select","Select",""],["","00093720298","PRAVASTATIN","TAB 40MG","90","Select","Select",""],["","93216568","NALOXONE","SPR ","2","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","00603497528","OXYBUTYNIN","TAB 5MG","90","Select","Select",""],["","65862019405","FLUOXETINE","CAP 40MG","90","Select","Select",""],["","33332032001","AFLURIA","INJ 2020-21","0.5","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","6","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00228202750","ALPRAZOLAM","TAB 0.25MG","25","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","90","Select","Select",""],["","42858030201","HYDROMORPHON","TAB 4MG","15","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","42","Select","Select",""],["","49281042250","FLUZONE","INJ 2022-23","0.5","Select","Select",""],["","56151014701","TRUPLUS","MIS 33G","100","Select","Select",""],["","5200010","PREVNAR","INJ ","0.5","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","30","Select","Select",""],["","310737220","BUDES\/FORMOT","AER 80-4.5","10.2","Select","Select",""],["","00093742698","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","14","Select","Select",""],["","59267102504","PFIZER","INJ ADLT RTU","0.3","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","15","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","00002879959","HUMALOG","INJ 100\/ML","12","Select","Select",""],["","65162074510","PROMETHAZINE","TAB 12.5MG","30","Select","Select",""],["","59762007301","HYDROCORT","TAB 5MG","120","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","19515081852","FLULAVAL","INJ 2021-22","0.5","Select","Select",""],["","17478071130","LIDOCAINE","GEL 2% JELLY","30","Select","Select",""],["","60505036301","OFLOXACIN","DRO 0.3%OTIC","5","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","59676080030","SYMTUZA","TAB ","30","Select","Select",""],["","43386035701","HYDROCO\/APAP","TAB 7.5-325","12","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","300","Select","Select",""],["","70710101002","OSELTAMIVIR","CAP 75MG","10","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":""}]}]}