{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" NORAHSELLIVUA","gend":1,"add":" .TPA ,.EVA AINIGRIV 1051                      551","city":"HARRISONBURG             ","state":"VA","zip":"22802-9998","dob":"1954-12-31","age":"","mstatus":"","insh":"10113760","cliId":"","pno":"2204555651","cno":"","email":"","ename":"","eno":"","pphy":"DAVIES, CATHERINE WINIFRED","ppno":5409325687,"pcpadd":"53 S MEDICAL PARK DR,","pcpcity":"Fishersville","pcpstate":"VA","pcpzip":229392333,"pcpcounty":"","pcpid":"","pcpname":"AUGUSTA HEALTH FISHERVILLE PRIMARY CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1501 VIRGINIA AVE., APT. 155                      ","madd2":"                                                  ","madd3":"","mcity":"HARRISONBURG             ","mstate":"VA","mzip":"22802-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.21","F11.20","Z79.891","Z79.899","M17.11","M17.0","K59.00","I10","Z68.32","F33.9","I47.1","E11.9","M17.12","M25.562","M54.5","W19.XXXA","R10.2","S39.92XA","W01.0XXA","Z87.891","Z12.31","Z13.820","Z78.0","M85.89","E11.65","E78.5","Z45.018","I46.9","M25.561","G89.29","M94.261","S83.241A","Z95.0","Z79.4","H25.13","I25.119","I44.2","N30.01","R35.0","B96.20","Z88.8","Z91.030","Z12.11","Z23","F33.0","B35.1"," ","L60.0","M79.675"],"date":["2022-11-14","2022-11-16","2022-11-16","2022-10-19","2022-11-17","2022-11-22","2022-07-18","2022-09-09","2022-07-18","2022-01-18","2022-05-24","2022-12-06","2022-11-17","2021-01-27","2021-01-30","2021-01-30","2021-01-30","2021-01-30","2021-01-30","2021-12-14","2022-02-10","2022-02-10","2022-02-10","2022-02-10","2022-09-09","2022-09-09","2022-10-28","2022-10-28","2020-05-18","2020-05-18","2020-08-27","2020-11-04","2020-12-12","2021-10-21","2022-03-31","2020-10-28","2022-05-24","2020-12-12","2020-12-12","2020-12-12","2020-12-12","2020-12-12","2021-12-14","2021-12-14","2022-05-16","2022-12-06","2022-12-06","2022-12-06","2022-12-06"],"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":[["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","MIS LANCETS","100","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","30","Select","Select",""],["","00093816501","QUETIAPINE","TAB 400MG","30","Select","Select",""],["","65862022960","LAMOTRIGINE","TAB 150MG","180","Select","Select",""],["","08290328468","INSULIN","MIS 0.5\/31G","100","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","75","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","45802014167","CICLOPIROX","SOL 0.08","6.6","Select","Select",""],["","76385012810","METFORMIN","TAB 500MG ER","120","Select","Select",""],["","70377002811","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","100","Select","Select",""],["","00169750111","NOVOLOG","INJ 100\/ML","10","Select","Select",""],["","00781723864","BUPREN\/NALOX","MIS 8-2MG","75","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","10","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","14","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":""}]}]}