{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"T YRNEHSNOMMI","gend":0,"add":"         EVA KRAP KAO 808                         ","city":"RICHMOND                 ","state":"VA","zip":"23222-9998","dob":"1951-01-26","age":"","mstatus":"","insh":"00119415","cliId":"","pno":"1340897469","cno":"","email":"","ename":"","eno":"","pphy":"MASON-WALKER, JEANNIE E.","ppno":8043298510,"pcpadd":"2421 CHAMBERLAYNE AVE,","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232224205,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS MEDICAL GROUP RICHMOND PRIMARY CARE LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"808 OAK PARK AVE                                  ","madd2":"                                                  ","madd3":"","mcity":"RICHMOND                 ","mstate":"VA","mzip":"23222-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E78.00","R30.0","R74.8","C61","Z68.34","U07.1","R05","Z20.89","H35.372","T63.481A","L29.9","I10","B00.9","E78.2","K08.89","E55.9","R43.0","R43.2","M25.572","Z82.49","I48.0","I42.9","Z01.810","R94.31","Z00.00","R10.13","R10.84","M25.552","M25.551","R10.32","G89.29","Z68.35","R94.5","T84.061A","Z96.643","E66.9","Z12.5","Z11.59","Z13.220","Z13.1","Z12.11","R31.21","Z96.642","Z79.899","M25.559","M85.88","M47.817","R31.29","R97.20","N41.9","E66.01","N41.1","T78.40XD","T78.3XXA","R22.0","N40.0","R31.0","K86.89","I70.0","R31.9","Z01.812","Z20.822","K63.5","D12.3","K57.30","K64.8","K64.4","Z87.438","R39.11","I48.91","N48.89","N50.82","H33.002","H25.13","Z71.2","L30.9","H40.053","N50.811","N50.812","I86.1","R39.89","Z80.42","D89.89","Z68.32","I45.10","N17.9","Z20.828","M19.90","Z79.01","F17.200","F12.90","K59.00","R40.2143","R40.2363","R40.2253","R07.89","R07.9","M77.32","M79.89","R10.30","K58.1","Z13.5","Z76.89","I42.2","R06.00","N52.9","I51.9","H40.013","Z01.818","H25.11","H25.12","Z98.42","Z96.1","I50.9","I83.813","J30.89","Z23","H04.123","Z86.69","H40.1122","H40.1111","E78.5","N43.41","N50.3","N43.40"," "],"date":["2020-01-20","2022-07-27","2020-01-20","2022-07-27","2021-08-25","2021-02-11","2021-01-20","2021-01-20","2022-10-17","2020-01-25","2020-01-25","2022-05-24","2022-02-03","2021-12-10","2021-02-11","2021-12-10","2021-02-11","2021-02-11","2021-02-11","2021-02-11","2021-08-30","2022-05-24","2021-08-30","2021-08-30","2021-12-10","2019-03-26","2019-04-01","2019-04-08","2019-04-04","2019-03-26","2021-09-02","2021-12-10","2019-04-01","2019-04-08","2021-05-19","2021-08-10","2019-04-04","2019-04-04","2019-04-04","2019-04-04","2021-12-12","2019-04-04","2022-05-24","2022-05-24","2019-04-08","2019-04-08","2019-04-08","2021-05-19","2020-10-08","2019-04-18","2021-12-10","2020-07-21","2020-05-18","2020-05-12","2020-05-12","2021-05-20","2021-05-19","2021-05-19","2021-05-19","2021-05-20","2021-06-29","2022-05-24","2021-07-01","2021-07-01","2021-07-01","2021-07-01","2021-07-01","2020-07-15","2021-08-10","2022-05-24","2021-08-10","2022-05-24","2021-09-23","2022-06-16","2021-12-10","2021-08-25","2021-12-16","2021-09-02","2021-09-02","2022-05-24","2021-09-02","2019-09-06","2019-09-25","2019-09-23","2020-10-01","2020-10-04","2020-10-01","2021-11-09","2022-05-24","2020-10-01","2020-10-01","2020-10-01","2020-10-01","2020-10-01","2020-10-01","2020-10-01","2020-10-02","2020-10-02","2020-10-02","2020-10-08","2020-11-11","2020-10-08","2021-11-24","2020-10-15","2020-10-15","2020-10-20","2020-10-20","2020-10-21","2022-05-18","2021-11-16","2021-11-09","2021-11-10","2022-10-17","2021-11-16","2021-12-10","2021-12-10","2021-12-10","2021-12-16","2021-12-16","2022-10-17","2022-10-17","2022-05-24","2022-05-04","2022-05-04","2022-05-24","2022-10-17"],"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":[["","68682000710","DILTIAZEM","TAB 60MG","120","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","59267030402","PFIZER","INJ BA4\/BA5","0.3","Select","Select",""],["","49281012065","FLUZONE","INJ PF 20-21","0.7","Select","Select",""],["","23155053006","TROSPIUM","TAB 20MG","10","Select","Select",""],["","65162004710","OXYCODONE","TAB 5MG","12","Select","Select",""],["","68645049659","CARVEDILOL","TAB 25MG","60","Select","Select",""],["","55111012701","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","24208046325","LATANOPROST","SOL 0.00005","2.5","Select","Select",""],["","42571014726","DORZOL\/TIMOL","SOL 22.3-6.8","10","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","3","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","00527293437","PREDNISONE","TAB 20MG","3","Select","Select",""],["","00093598627","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","6","Select","Select",""],["","60505001406","DILT-XR","CAP 120MG","90","Select","Select",""],["","00591024105","LORAZEPAM","TAB 1MG","1","Select","Select",""],["","51672131200","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","65862042001","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","68180063609","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","00228282011","HYDROCHLOROT","TAB 12.5MG","90","Select","Select",""],["","00781217660","CEFDINIR","CAP 300MG","6","Select","Select",""],["","42806055212","OMEGA-3-ACID","CAP 1GM","30","Select","Select",""],["","00168000415","TRIAMCINOLON","CRE 0.001","45","Select","Select",""],["","31722070490","VALACYCLOVIR","TAB 500MG","4.00","Select","Select",""],["","58914017014","CARAFATE","SUS 1GM\/10ML","414","Select","Select",""],["","68382009601","HYDROXYCHLOR","TAB 200MG","60","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","68645053254","LISINOPRIL","TAB 20MG","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":""}]}]}