{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" J ARABRABNOSREFFEJ","gend":1,"add":"       TS RETSEHCROD 8961                         ","city":"FRANKLIN                 ","state":"VA","zip":"23851-9998","dob":"1964-12-11","age":"","mstatus":"","insh":"10114535","cliId":"","pno":"5675742310","cno":7576185731,"email":"","ename":"","eno":"","pphy":"WILLIAMS, MICHAEL","ppno":7579838600,"pcpadd":"114 N MAIN ST STE 200,STE 200","pcpcity":"Suffolk","pcpstate":"VA","pcpzip":234344564,"pcpcounty":"","pcpid":"","pcpname":"SENTARA INTERNAL MEDICINE PHYSICIANS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APT B6                                            ","add3":"","madd1":"1698 DORCHESTER ST                                ","madd2":"APT B6                                            ","madd3":"","mcity":"FRANKLIN                 ","mstate":"VA","mzip":"23851-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.65","I50.42","E78.5","N39.46","E11.9","I63.9","L22","G82.50","L89.102","M54.2","M25.511","M54.40","V89.2XXD","E55.9","E78.2","E11.8","M54.12","M54.41","M54.42","M54.5","M47.899","I42.0","Z95.810","I10","Z79.4","I69.351","F33.2","J41.0","R56.9","E66.01","K21.9","G89.29","F33.1","I42.8","R35.0","N30.01","I25.10","I50.22","R07.89","R07.9","G44.89","E11.40","I11.0","Z86.16","Z79.899","Z80.9","Z82.49","Z82.5","Z82.61","Z86.73","Z20.822","F32.A","R77.8","Z86.79","Z79.810","I95.9","Z88.6","Z88.8","Z91.018","R52","R10.9","I50.9","J98.11","I50.20","I50.23","A41.89","U07.1","I50.43","B96.20","D64.9","E87.6","E66.9","Z68.34","E83.42","A41.9","N30.90","R07.81","R73.9","R06.02","R79.1","Z68.35","R50.81","I82.403","Z09","I50.30","E11.649","Z83.49","K59.00","Z68.33","R68.83","E16.2","Z20.828","B97.29","D50.8","J12.82","E11.42","Z68.36","R91.8","B37.3","G43.009","E11.3411","E11.3412","H25.11","H25.12","R00.0","M94.0","R09.02","R06.89","J96.01","N39.0","B96.1","T38.0X5A","J81.1","I51.7","I50.21","R55","G62.9","G43.709","G56.03","R58","G60.3","R68.89","R25.2","I50.32","I42.9","R60.0","G43.109","Z00.00","M62.830","R51","R42","Z90.49","Z79.84","M54.9","R82.71","Z11.59","N30.00","R65.21","R09.89","M54.6","R26.2","F32.0","G43.001","R39.9","G89.4","R40.4","F41.9","G43.909","R51.9","R41.82","E78.00","H60.313","Z98.890","Z51.81","E11.10","M25.561","M25.551","V87.7XXA","S89.91XA","M79.661","M79.604","V48.0XXA","R10.31","M79.651","R06.00","R79.89","S79.921A","S39.93XA","S39.91XA","S29.9XXA","S19.9XXA","V89.2XXA","D58.2","R60.9","F33.0","F41.1","Z12.11","G47.00","Z99.89","M19.90","M51.36","I49.3","H40.1130","I27.20","Z68.30","N89.8","E11.3392","H25.013","H25.13","N17.9","N18.31","H40.052","I51.9","N12","N18.30","N28.9","R11.2","N19","E11.00","I13.0","A04.72","E11.22","G25.81","S22.41XA","X58.XXXA"," ","J11.1","I82.623","H40.1132","B96.89","R94.39","E11.21","J98.6","Z71.89","I34.1","H40.1122","H26.9","H40.1112","S22.31XS"],"date":["2022-12-11","2022-08-04","2022-12-06","2022-03-10","2022-12-02","2022-03-10","2022-03-10","2022-03-10","2022-03-10","2021-01-08","2022-12-08","2022-06-20","2022-08-02","2021-01-08","2022-04-06","2022-08-02","2021-08-03","2021-08-26","2021-08-26","2021-01-11","2021-01-11","2022-07-14","2022-12-02","2022-12-05","2022-11-10","2022-08-02","2022-08-02","2022-08-02","2022-08-02","2022-08-02","2022-09-21","2022-06-20","2022-09-07","2022-12-06","2022-04-08","2022-02-11","2022-06-20","2022-09-27","2022-09-21","2022-09-26","2022-02-15","2022-06-10","2022-11-30","2022-02-15","2022-04-06","2022-02-15","2022-02-15","2022-02-15","2022-02-15","2022-04-06","2022-02-15","2022-09-21","2022-02-15","2022-02-15","2022-02-16","2022-09-23","2022-02-18","2022-02-18","2022-02-18","2022-02-18","2022-06-10","2022-11-30","2022-02-18","2022-02-23","2022-12-11","2021-03-01","2021-12-10","2021-12-21","2021-04-06","2022-06-10","2022-06-12","2022-09-21","2021-12-21","2021-04-06","2021-03-03","2021-03-03","2022-11-03","2022-06-20","2022-09-26","2021-03-01","2021-03-02","2021-03-03","2022-08-02","2021-04-30","2021-03-04","2021-04-06","2021-03-05","2021-03-05","2021-03-05","2021-03-05","2021-03-05","2021-03-05","2021-03-05","2021-11-16","2021-03-09","2022-09-21","2021-03-09","2021-03-09","2021-03-22","2021-10-13","2022-11-10","2022-11-10","2022-06-17","2022-11-15","2022-12-01","2022-09-21","2021-05-31","2021-04-06","2021-04-06","2022-09-27","2022-09-21","2021-04-06","2021-04-06","2022-06-13","2022-09-27","2021-12-10","2021-08-03","2021-12-21","2021-08-03","2021-05-31","2021-06-01","2021-11-20","2021-08-20","2021-07-15","2021-11-19","2020-12-08","2020-10-28","2022-08-02","2021-10-13","2020-08-30","2020-08-30","2020-10-20","2020-10-20","2020-12-20","2020-10-28","2020-10-28","2022-09-12","2020-10-28","2020-10-29","2020-10-29","2020-10-31","2021-12-03","2021-11-12","2021-11-16","2022-09-21","2021-11-19","2021-11-23","2022-09-27","2021-11-17","2021-11-19","2021-11-23","2020-12-03","2020-12-08","2020-12-08","2020-12-21","2020-12-20","2020-12-20","2020-12-21","2020-12-20","2020-12-20","2020-12-20","2020-12-20","2020-12-20","2020-12-20","2022-12-01","2020-12-20","2020-12-20","2020-12-20","2020-12-20","2020-12-20","2020-12-20","2020-12-28","2020-12-21","2022-08-04","2021-12-21","2022-09-21","2021-12-21","2020-12-22","2020-12-22","2020-12-22","2020-12-22","2022-04-05","2022-03-28","2022-11-30","2022-04-06","2022-04-08","2022-03-14","2022-03-14","2022-03-14","2022-09-27","2022-06-12","2022-11-10","2022-06-13","2022-06-20","2022-06-11","2022-06-20","2022-08-02","2022-06-10","2022-06-17","2022-06-17","2022-06-10","2022-06-10","2022-06-10","2022-06-28","2022-06-28","2022-12-11","2022-11-03","2022-12-08","2022-11-15","2022-09-21","2022-12-09","2022-12-02","2022-09-21","2022-06-10","2022-12-01","2022-11-15","2022-11-22","2022-11-22","2022-09-12"],"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":[["","16729017217","AMITRIPTYLIN","TAB 25MG","90","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","50383023310","DORZOL\/TIMOL","SOL 22.3-6.8","20.00","Select","Select",""],["","31722070190","LOSARTAN","TAB 50MG","90","Select","Select",""],["","08290309629","INSULIN","MIS 1ML","500","Select","Select",""],["","24208041110","BRIMONIDINE","SOL 0.2% OP","20.00","Select","Select",""],["","42043022109","SUMATRIPTAN","TAB 50MG","9","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","50228018001","GABAPENTIN","CAP 300MG","270","Select","Select",""],["","67877019705","AMLODIPINE","TAB 2.5MG","90","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","15","Select","Select",""],["","93598627","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","00169750111","NOVOLOG","INJ 100\/ML","10","Select","Select",""],["","68180063609","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","45","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","8627002011","G4","MIS RECEIVER","1","Select","Select",""],["","00172392660","DIAZEPAM","TAB 5MG","12","Select","Select",""],["","99073070822","FREESTYLE    TES LITE","TES LITE","50","Select","Select",""],["","00527143501","METAXALONE","TAB 800MG","30","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","90","Select","Select",""],["","43547026810","ROPINIROLE","TAB 0.25MG","90","Select","Select",""],["","65862019105","CYCLOBENZAPR","TAB 10MG","30","Select","Select",""],["","68382009401","CARVEDILOL","TAB 12.5MG","180","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","1","Select","Select",""],["","16729022501","SPIRONOLACT","TAB 25MG","30","Select","Select",""],["","50111032801","HYDRALAZINE","TAB 50MG","180.00","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","00078077720","ENTRESTO","TAB 49-51MG","180","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","00193731221","CONTOUR","TES NEXT","100","Select","Select",""],["","56151014401","TRUPLUS","MIS 30G","100","Select","Select",""],["","65162062710","TRAMADOL","TAB 50MG","12","Select","Select",""],["","50383002510","OFLOXACIN","DRO 0.3%OTIC","10","Select","Select",""],["","13668010401","ISOSORB","TAB 30MG ER","30.00","Select","Select",""],["","99073013001","FREESTYLE    MIS LANCETS","MIS LANCETS","100","Select","Select",""],["","65862052890","VENLAFAXINE","CAP 75MG ER","90","Select","Select",""],["","10702025301","BUT\/APAP\/CAF","TAB ","12","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20","Select","Select",""],["","67877052560","RANOLAZINE","TAB 500MG ER","60.00","Select","Select",""],["","50742061501","METOPROL","TAB 25MG ER","90","Select","Select",""],["","68462063945","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","67877021901","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","50111078710","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","64380083406","ACETAZOLAMID","TAB 250MG","60","Select","Select",""],["","69238149101","BUMETANIDE","TAB 2MG","180.00","Select","Select",""],["","00406051201","OXYCOD\/APAP","TAB 5-325MG","18","Select","Select",""],["","68382080501","TRAZODONE","TAB 50MG","90","Select","Select",""],["","51672130200","TERCONAZOLE","CRE 0.008","20","Select","Select",""],["","43547035210","LISINOPRIL","TAB 5MG","90","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","59267102504","PFIZER","INJ ADLT RTU","0.30","Select","Select",""],["","55513084301","AIMOVIG","INJ 140MG\/ML","1","Select","Select",""],["","52817031910","BACLOFEN","TAB 5MG","30","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","8317234132","PEN  NEEDLES","MIS 32GX4MM","100","Select","Select",""],["","57599080000","FREESTY","KIT 2 SENSOR","1","Select","Select",""],["","62559039050","VANCOMYCIN","CAP 125MG","40","Select","Select",""],["","69238174608","PILOCARPINE","SOL 2% OP","15","Select","Select",""],["","00121168016","POT  CHLORIDE","SOL 0.1","120.00","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":["",""],"sub":{"indx":[["","",""],[""],[""],[""],[""]],"comment":[["","",""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}