{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BA NIVLAYHTANRE","gend":0,"add":"       TEERTS NOTRUB 0042                         ","city":"RICHMOND                 ","state":"VA","zip":"23223-6466","dob":"1964-09-23","age":"","mstatus":"","insh":"10111850","cliId":"","pno":"7740818711","cno":"","email":"","ename":"","eno":"","pphy":"COVINGTON, DAMIAN L","ppno":8042257177,"pcpadd":"1510 N 28TH ST STE 300,","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232235311,"pcpcounty":"","pcpid":"","pcpname":"DOMINION MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APARTMENT 207                                     ","add3":"","madd1":"2400 BURTON STREET                                ","madd2":"APARTMENT 207                                     ","madd3":"","mcity":"RICHMOND                 ","mstate":"VA","mzip":"23223-6466","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H40.1132","E11.9","H40.1133","R00.0","N18.30","Z94.0","E08.22","Z79.4","Z45.2","E11.65","E78.5","E11.319","I10","R89.9","Z92.29","R06.02","B35.1","E11.649","E16.0","Y83.0","T86.19","Z20.822","E11.22","I12.9","I45.10","N17.9","T38.3X5A","H54.61","K59.00","Z75.1","Z91.89","Z68.34","R79.9","R79.89","R53.1","R63.4","Z48.22","N18.2","Z79.84","Z79.899","S81.802D","H40.1131","R80.9","R41.89","R41.82","G31.9","I11.9","Z68.32","N18.6","E10.43","M79.673","N18.9","E16.2","K21.9","Z79.82","N18.32","R68.89","E55.9","E53.8","R35.1","Z87.891","I25.10","E66.9","Z23","M79.671","M79.672","D84.821","I12.0","E11.21","E13.9","E11.69","Z94.4","I11.0","E11.59","N25.81","D64.9","N26.1","H54.8","E27.49","Z68.33","T50.905A","E10.649","H25.13","Z68.30","H54.40","H25.12","H40.1121","H47.212","H34.8122","H40.9","H34.8111","H40.012","Z68.27","E11.00"," ","Z01.818","H40.1123"],"date":["2022-04-05","2022-10-11","2022-10-11","2022-04-16","2022-05-12","2022-10-19","2022-05-12","2022-09-29","2021-02-05","2022-04-17","2022-04-23","2022-11-11","2022-12-06","2022-10-11","2022-10-11","2022-03-28","2022-07-20","2022-04-27","2022-04-27","2022-04-17","2022-04-17","2022-04-17","2022-11-11","2022-04-17","2022-04-17","2022-04-17","2022-04-27","2022-04-17","2022-04-23","2022-04-17","2022-10-19","2020-12-30","2022-10-11","2022-10-11","2020-09-30","2020-09-30","2021-05-26","2020-10-26","2022-04-18","2022-04-23","2020-02-13","2021-09-15","2022-04-18","2021-08-23","2022-04-17","2022-04-17","2022-03-28","2022-05-10","2022-10-11","2022-07-20","2022-07-20","2022-04-23","2022-04-16","2022-04-16","2022-04-16","2022-04-27","2022-10-11","2022-10-11","2022-10-11","2022-10-11","2020-02-21","2020-02-21","2020-02-21","2022-11-14","2020-06-17","2020-06-17","2022-04-18","2022-04-23","2022-04-18","2022-04-26","2022-09-29","2022-04-22","2021-06-14","2021-06-14","2020-01-21","2020-01-21","2022-04-16","2021-09-29","2022-04-23","2021-03-29","2022-04-16","2022-04-16","2022-10-11","2022-06-28","2022-06-28","2022-10-26","2022-08-05","2022-08-05","2022-08-25","2022-08-25","2022-08-25","2022-08-22","2022-11-11","2022-09-29","2022-12-06","2022-11-11","2022-10-26"],"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":[["","00469061773","PROGRAF","CAP 1MG","360","Select","Select",""],["","64380072106","TACROLIMUS","CAP 1MG","300","Select","Select",""],["","00023932105","ALPHAGAN","SOL 0.001","15","Select","Select",""],["","65862020290","LOSARTAN","TAB 50MG","90","Select","Select",""],["","00065414727","SIMBRINZA","SUS 1-0.2%","24","Select","Select",""],["","00597015230","JARDIANCE","TAB 10MG","30","Select","Select",""],["","00603533732","PREDNISONE","TAB 5MG","30","Select","Select",""],["","00054016325","MYCOPHENOLAT","CAP 250MG","120","Select","Select",""],["","08484072500","PRODIGY","TES CODING","100","Select","Select",""],["","53746051101","SPIRONOLACT","TAB 25MG","90","Select","Select",""],["","00169255013","TRESIBA","INJ 200UNIT","9","Select","Select",""],["","76385012810","METFORMIN","TAB 500MG ER","360","Select","Select",""],["","00093720198","PRAVASTATIN","TAB 20MG","90","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","24208046325","LATANOPROST","SOL 0.00005","7.5","Select","Select",""],["","57664047758","METOPROL","TAB 50MG","270","Select","Select",""],["","00378021610","FUROSEMIDE","TAB 40MG","180","Select","Select",""],["","00006027731","JANUVIA","TAB 100MG","90","Select","Select",""],["","00065027510","AZOPT","SUS 1% OP","30","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","61314012605","KETOROLAC","SOL 0.005","5","Select","Select",""],["","61314063705","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","64980051505","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","24208048510","DORZOLAMIDE","SOL 2% OP","20","Select","Select",""],["","53885000810","ONETOUCH","MIS PLUS 33G","100","Select","Select",""],["","08470354001","UNFINE","MIS 32GX4MM","100","Select","Select",""],["","574402435","ERYTHROMYCIN","OIN 5MG\/GM","3.5","Select","Select",""],["","49281042150","FLUZONE","INJ 2021-22","0.5","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","MIS LANCETS","100","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","2","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","3","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":""}]}]}