{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AIHTNYCRETRAC ","gend":1,"add":"      EUNEVA SDRAWDE 9061                         ","city":"RICHMOND                 ","state":"VA","zip":"23224-9998","dob":"1953-09-20","age":"","mstatus":"","insh":"10113653","cliId":"","pno":"7240826267","cno":8049390559,"email":"","ename":"","eno":"","pphy":"ELLIOTT, CHARMAINE N","ppno":8046441665,"pcpadd":"1510 N 28TH ST STE 301,","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232235311,"pcpcounty":"","pcpid":"","pcpname":"PRIMARY HEALTCARE ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1609 EDWARDS AVENUE                               ","madd2":"                                                  ","madd3":"","mcity":"RICHMOND                 ","mstate":"VA","mzip":"23224-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N18.9","R53.1","E11.65","E11.22","I10","G95.9","N18.30","Z79.4","E55.9","F41.9","E53.8","I25.10","E78.2","F41.1","A00.0","H35.033","E11.3413","Z96.1","H25.11","E11.621","L97.529","M79.672","E78.5","Z79.82","Z87.891","F32.9","G89.4","I12.9","N18.3","E66.9","Z95.1","Z95.0","R26.89","B35.1","L89.623","E11.42","Z00.00","E11.43","Z20.828","K31.84","K21.9","E78.00","I25.2","D64.9","K27.9","F51.01","E83.52","R60.0","N28.9","E86.9","R07.9","R10.9","R11.10","R11.2","N17.9","R73.9","R00.0","M25.512","J69.0","E87.2","N39.0","F33.0","K44.9","K31.9","L89.899","E86.0","R09.02","Z11.59","R06.02","E11.9","J18.9","R10.84","J98.4","M48.061","M48.07","M54.6","J98.11","L97.522","Z45.2","K29.50","K31.89","K29.70","I11.9","E11.40","H53.8","H26.9","L97.429","R27.9","R53.81","E11.21","M47.12","M54.9","I21.4","K25.9","K59.2","J45.909","K30","J96.01","J15.9","R00.1","I49.5","M48.02","Z68.32","G72.81","E11.69","F99","Z76.89","R20.9","D51.9","G89.29","L89.322","L89.312","Z12.11","Z01.818","H01.00A","R05.9","R09.81","R07.89","H17.9","M54.12","F32.A","Z89.412","Z86.31","R30.0","H01.00B","H10.402","H16.223","N18.4","Z68.33","R10.13","Z86.2","M19.90"," ","M25.50","Z78.0","Z13.820","E78.1","D50.9","K59.04","M79.10"],"date":["2021-05-17","2022-12-11","2022-12-06","2022-07-25","2022-12-06","2022-01-27","2022-03-05","2022-12-06","2022-12-06","2022-01-27","2022-01-27","2022-12-01","2022-12-06","2022-12-01","2022-02-03","2022-07-15","2022-07-15","2022-07-15","2022-07-15","2021-06-07","2021-05-04","2021-05-04","2022-01-15","2022-03-05","2022-07-25","2021-05-04","2020-12-02","2022-07-25","2020-09-03","2020-12-02","2022-07-25","2022-11-07","2020-12-02","2022-06-13","2021-07-11","2022-06-13","2022-03-21","2022-07-25","2020-05-27","2022-07-25","2022-07-25","2022-07-25","2022-07-25","2020-07-01","2020-05-27","2020-05-25","2020-05-25","2020-05-25","2020-05-25","2020-05-27","2022-01-15","2022-07-25","2020-05-25","2022-07-25","2020-06-20","2020-05-25","2020-05-25","2020-05-27","2020-06-16","2020-06-13","2020-06-13","2020-06-10","2020-06-09","2020-06-02","2020-06-02","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2022-01-15","2020-06-27","2020-06-03","2022-01-15","2022-12-01","2020-06-06","2020-06-06","2020-06-06","2021-06-11","2020-06-08","2020-06-09","2020-06-09","2020-06-09","2021-07-11","2021-07-11","2021-07-11","2021-07-11","2021-06-11","2020-06-17","2020-06-20","2020-06-29","2020-06-17","2020-06-17","2020-06-17","2020-06-17","2020-06-17","2020-06-17","2020-06-17","2020-06-29","2020-06-29","2022-11-07","2022-11-07","2021-06-18","2022-03-21","2020-06-27","2020-06-20","2020-07-01","2020-07-01","2021-08-02","2022-12-01","2020-08-26","2020-12-02","2020-12-02","2021-09-20","2021-11-12","2020-12-30","2022-01-15","2022-01-15","2022-01-15","2022-07-15","2022-03-05","2022-03-05","2022-03-05","2022-03-05","2022-03-03","2022-07-15","2022-04-07","2022-04-07","2022-06-27","2022-06-27","2022-07-25","2022-07-25","2022-07-25","2022-12-11","2022-12-06","2022-12-01","2022-12-01","2022-12-01","2022-12-01","2022-12-01","2022-12-01"],"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":[["","60505024801","MIRTAZAPINE","TAB 30MG","30","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","10","Select","Select",""],["","00093505898","ATORVASTATIN","TAB 40MG","90.00","Select","Select",""],["","00555032302","HYDROXYZ","CAP 25MG","60","Select","Select",""],["","45802008801","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","17478007035","ERYTHROMYCIN","OIN 5MG\/GM","3.5","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","6.00","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","21","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","24","Select","Select",""],["","29033000305","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","64380078706","BUSPIRONE","TAB 7.5MG","90","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","68645051654","AMLODIPINE","TAB 10MG","45","Select","Select",""],["","70010010810","GABAPENTIN","CAP 100MG","90.00","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","100","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","42","Select","Select",""],["","66733082259","INSULIN","INJ 100\/ML","15","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","MIS LANCETS","100","Select","Select",""],["","61314063006","NEO\/POLY\/DEX","SUS 0.1% OP","5.00","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30.00","Select","Select",""],["","63304090090","FENOFIBRATE","TAB 54MG","30.00","Select","Select",""],["","57664050658","METOPROL","TAB 25MG","180.00","Select","Select",""],["","00093220401","METOCLOPRAM","TAB 5MG","40","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","20","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14.00","Select","Select",""],["","17478071310","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","10702000709","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":[]}]},{"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":""}]}]}