{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ADNILREHSIF","gend":1,"add":"  NL YELLAV TNASAELP 6831                         ","city":"KESWICK                  ","state":"VA","zip":"22947-9998","dob":"1959-12-11","age":"","mstatus":"","insh":"10113116","cliId":"","pno":"7943493561","cno":"","email":"","ename":"","eno":"","pphy":"MULLER, RICHARD A","ppno":4349731831,"pcpadd":"65 BRICKYARD DR,","pcpcity":"Dillwyn","pcpstate":"VA","pcpzip":239363361,"pcpcounty":"","pcpid":"","pcpname":"BUCKINGHAM FAMILY MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1386 PLEASANT VALLEY LN                           ","madd2":"                                                  ","madd3":"","mcity":"KESWICK                  ","mstate":"VA","mzip":"22947-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.9","R07.89","Z23","R07.2","N18.9","Z85.118","Z87.891","D64.9","D72.821","F10.10","K21.9","G40.909","F10.239","K85.90","G93.41","K56.609","K56.7","K42.9","D72.829","R74.8","E78.5","Z87.19","Z90.2","R25.2","R00.0","Z13.6","E87.2","F10.20","R11.2","N17.9","E87.5","R91.8","E44.0","Z68.1","E55.9","E53.8","M81.0","F32.A","Z79.83","D50.0","C34.92","J44.9","K76.0","R10.84","Z09","E83.42","M79.662","Z12.31","R79.1","H92.01","M79.672","A41.9","E43","E87.1","G47.62","Z79.899","Z96.643","Z13.820","Z78.0","R91.1","Z11.59","Y90.0","F10.131","E86.0","K29.20","K21.00","T73.0XXA","F32.9","H54.7","R10.31","R10.32","K63.89","R10.13","Z46.82","R11.10","Z92.21","Z92.3","N39.0","K86.0","H91.90","Z87.81","C34.12","M1A.9XX0","D53.9","Z45.2","K85.20","E83.39","K29.70","E86.1","F32.4","K42.0","Y90.6","Z20.822","R73.9","I95.9","R10.9","E78.2","J43.9","E16.2","D50.8","F10.21","M25.512","G89.29","K20.90","K29.50","Z00.00","R79.89","D63.1","M10.072","K52.9","Z78.9","R16.0","R13.10","M54.9","M54.50","R93.3","K22.89","K31.89"," ","M54.12","R78.81","B95.8","I33.0","F41.9","D72.828","M79.604","M79.605"],"date":["2022-09-07","2022-09-08","2021-10-11","2021-04-08","2022-09-07","2022-06-02","2022-05-06","2022-05-11","2022-09-07","2022-05-05","2022-02-03","2022-09-07","2022-09-07","2021-07-08","2021-07-12","2021-08-17","2021-08-11","2021-08-11","2022-09-29","2021-08-11","2022-09-07","2021-08-11","2021-12-23","2020-10-01","2022-09-07","2020-10-01","2022-09-08","2022-11-03","2022-09-08","2022-06-24","2022-05-04","2022-03-10","2022-03-10","2022-06-22","2022-09-07","2022-09-07","2022-05-04","2022-09-07","2021-12-18","2022-11-03","2021-10-11","2022-09-07","2022-03-10","2022-05-04","2022-09-21","2022-06-24","2021-08-27","2021-12-03","2022-09-07","2021-03-07","2021-03-07","2021-08-11","2022-06-22","2022-09-29","2021-10-11","2022-09-12","2022-01-21","2021-02-23","2021-02-23","2022-03-24","2020-10-01","2021-03-06","2021-03-06","2022-09-07","2022-11-03","2022-09-07","2021-03-06","2021-03-06","2022-05-04","2022-06-22","2021-03-06","2021-08-11","2021-08-11","2021-08-11","2022-05-04","2022-03-10","2022-03-10","2021-08-11","2021-08-11","2021-08-11","2021-08-11","2022-04-18","2021-03-12","2021-03-12","2021-04-08","2021-07-07","2021-07-07","2022-05-04","2022-03-10","2022-02-03","2021-08-20","2022-03-10","2022-09-07","2022-03-10","2022-03-11","2022-09-08","2022-03-11","2022-04-18","2022-03-11","2022-03-14","2022-08-03","2022-04-06","2022-04-06","2022-09-07","2022-05-06","2022-06-02","2022-05-04","2022-05-04","2022-06-29","2022-06-24","2022-06-25","2022-06-22","2022-06-22","2022-06-22","2022-06-24","2022-05-06","2022-05-05","2022-05-05","2022-11-03","2022-09-29","2022-09-29","2022-09-29","2022-09-09","2022-09-07","2022-06-22","2022-09-07","2022-09-07"],"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":[["","65862032904","ALENDRONATE","TAB 70MG","12","Select","Select",""],["","59267102501","PFIZER","INJ ADLT RTU","0.3","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","65862024708","LEVETIRACETA","TAB 750MG","180","Select","Select",""],["","68462039710","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","68180016613","VANCOMYCIN","CAP 125MG","15","Select","Select",""],["","27808023302","DOXYCYCL","CAP 100MG","10","Select","Select",""],["","00406117003","NALTREXONE","TAB 50MG","90","Select","Select",""],["","00054429931","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","67877021620","CEFUROXIME","TAB 500MG","6","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","12.00","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","20","Select","Select",""],["","406055201","OXYCODONE","TAB 5MG","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":["",""]}},{"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":""}]}]}