{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  ETTEMAHCNAMELOC A ","gend":1,"add":"            RD YELSEW 241                         ","city":"DANVILLE                 ","state":"VA","zip":"24540-9998","dob":"1967-01-10","age":"","mstatus":"","insh":"10112062","cliId":"","pno":"2443434735","cno":"","email":"","ename":"","eno":"","pphy":"OTERO-TRUITT, TESSIE","ppno":4345755844,"pcpadd":"2232 WILBORN AVE STE A,","pcpcity":"South Boston","pcpstate":"VA","pcpzip":245921662,"pcpcounty":"","pcpid":"","pcpname":"HALIFAX ENDOCRINOLOGY AND OSTEOPOROSIS CENTER PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"142 WESLEY DR                                     ","madd2":"                                                  ","madd3":"","mcity":"DANVILLE                 ","mstate":"VA","mzip":"24540-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D47.2","D50.9","E03.9","E11.9","I10","E78.5","M54.42","K62.5","Z53.8","J44.9","F17.210","Z90.710","Z90.722","Z90.79","Z85.43","Z87.442","Z83.3","Z80.0","Z79.83","Z79.890","E11.22","Z79.4","N18.30","E04.1","E10.9","H40.023","E11.29","N18.2","I13.10","M76.62","E10.41","L60.0","L84","M79.672","B35.1","L11.0","L57.0","Z00.00","Z30.432","Z01.419","R06.02","R01.1","Z68.41","I44.0","E78.2","R94.31","I25.10","R06.09","R42","G89.29","M47.816","M25.561","M72.2","F32.0","M25.512","M19.012","R87.811","N18.3","E11.65","Z30.430","N95.1","N93.8","Z12.31","E78.00","Z01.818","F41.9","Z86.718","R10.84","K59.09","R10.13","Z86.010","K76.0","R16.0","K44.9","M25.572","N28.1","E03.8","M54.9","K21.9","K80.20","R10.9","N39.0","M54.6","N20.0","K76.9","R10.12","M54.41","G89.4","M79.604","M54.5","M54.89","R53.1","E13.9","M25.551","M25.552","F17.200","E11.21","R80.9","I12.9","M19.90","F12.90","Z99.89","H40.013","K57.30","Q43.8","G62.9","N18.9","G47.10","M79.609","M54.16","M79.2","M81.0","M85.832","Z78.0","Z12.2","Z12.11","R11.0","R19.8","E55.9","K29.50","K63.5","H52.13","H52.223","H52.4","R14.0","K29.70","K31.84","K62.1","E66.9","Z68.38","L53.9","T18.128A"," ","D23.72","F32.A"],"date":["2022-01-10","2022-01-10","2022-12-08","2022-12-08","2022-09-22","2022-09-21","2022-05-26","2022-03-08","2022-03-08","2022-01-26","2022-03-31","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-01-26","2022-09-21","2022-09-21","2022-09-21","2022-02-04","2021-10-20","2021-02-11","2022-09-22","2022-09-22","2022-09-12","2021-09-02","2021-03-05","2022-11-18","2021-03-05","2021-11-04","2021-03-05","2021-03-05","2021-03-05","2020-03-09","2020-03-09","2020-03-09","2020-03-17","2020-03-17","2020-12-18","2020-04-02","2020-12-18","2020-04-02","2020-04-02","2020-04-02","2020-04-02","2021-07-30","2020-07-17","2020-05-08","2021-07-29","2021-04-27","2021-04-30","2021-04-30","2021-05-05","2020-08-20","2020-08-20","2020-06-25","2020-06-25","2020-06-25","2022-10-28","2020-10-30","2020-08-23","2020-07-17","2020-07-17","2022-03-08","2022-11-08","2020-07-29","2022-11-08","2022-11-08","2022-11-08","2022-09-29","2021-07-30","2022-08-17","2020-08-20","2020-08-20","2022-11-08","2021-10-12","2021-09-27","2021-09-27","2021-09-27","2021-09-27","2021-10-12","2021-10-12","2020-10-30","2020-10-30","2020-10-30","2020-12-18","2020-10-30","2020-10-30","2020-11-02","2022-05-26","2021-11-15","2022-03-31","2022-03-22","2022-09-12","2020-12-18","2020-12-18","2020-12-18","2020-12-18","2021-10-20","2022-03-17","2022-03-17","2022-03-31","2022-09-12","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-03-31","2022-09-29","2022-06-30","2022-09-01","2022-09-22","2022-09-29","2022-09-29","2022-09-27","2022-09-27","2022-09-27","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-12-08","2022-11-18","2022-11-29"],"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":[["","43547033850","BENAZEPRIL","TAB 40MG","90","Select","Select",""],["","00378395305","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","2","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","08290320109","BD  PEN NEEDL","MIS 31GX8MM","100","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","7","Select","Select",""],["","69238183407","LEVOTHYROXIN","TAB 100MCG","90","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","60846080501","UNITHROID","TAB 100MCG","90","Select","Select",""],["","00006027754","JANUVIA","TAB 100MG","90","Select","Select",""],["","57664016758","METOPROL","TAB 100MG","60","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","90","Select","Select",""],["","65162017910","METFORMIN","TAB 750MG ER","30","Select","Select",""],["","00169633910","NOVOLOG","INJ FLEXPEN","15","Select","Select",""],["","00169406013","VICTOZA","INJ 18MG\/3ML","9","Select","Select",""],["","59762054202","GLIPIZIDE","TAB 10MG","30","Select","Select",""],["","68382050010","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","52268020101","SUTAB","TAB ","24","Select","Select",""],["","68462018905","NAPROXEN","TAB 375MG","20","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","57599080000","FREESTY","KIT 2 SENSOR","1","Select","Select",""],["","69097067905","PREGABALIN","CAP 75MG","60","Select","Select",""],["","00299382060","METROGEL","GEL 0.01","60","Select","Select",""],["","73070010315","INSULIN","INJ FLEXPEN","15","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","90","Select","Select",""],["","56151210301","PEN  NEEDLES","MIS 31GX5\/16","300","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":""}]}]}