{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"B AILICECNOTHGUOR","gend":1,"add":"          TC REDLUAC 7683                         ","city":"RICHMOND                 ","state":"VA","zip":"23224-9998","dob":"1991-07-11","age":"","mstatus":"","insh":"10114641","cliId":"","pno":"6640835816","cno":"","email":"","ename":"","eno":"","pphy":"BRITZ, JACQUELINE BAKER","ppno":8042307777,"pcpadd":"4730 N SOUTHSIDE PLAZA ST,","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232241742,"pcpcounty":"","pcpid":"","pcpname":"VCUHS HAYES E WILLIS HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"3867 CAULDER CT                                   ","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":["L73.9","N12","R11.2","R07.89","E10.9","E10.69","R09.81","B20","M54.5","G43.909","E10.65","J45.909","M79.89","N39.0","M94.0","K76.0","N28.89","N32.89","H27.02","H18.233","H34.8122","R10.84","R52","L02.32","L02.416","J11.1","E11.65","F32.9","Z01.818","M79.672","M79.671","H53.8","R51.9","R03.0","F17.200","R07.9","R22.0","J06.9","R05.9","A41.9","K61.1","L02.415","F32.A","F41.9","Z21","Z88.6","Z87.891","Z91.030","Z79.4","H26.492","L02.91","R10.13","R07.82","S92.422A","M25.562","M25.572","G89.29","Z79.2","E11.9","F32.3","B88.9","Z79.899","Z23","L03.211","L02.01","H54.8","M79.10","R50.9","I07.1","H34.8112","I44.5","R00.0","F17.210","H40.9","K59.09","L30.9","E10.8","R21","L70.8","R53.1","M25.50","L03.115","H40.1124","A08.4","R07.2","R06.02","H25.12","Z91.018","Z20.822","S80.212A","W18.30XA","S92.302A","H40.1134","R53.83","R07.81","M54.9","R10.9","L02.425","L02.426","Z86.59","M79.673","Z11.59","E10.319","E10.40","S81.802A","H25.89","R60.0","Z82.49","R22.43","R73.9","R10.0","R11.0","R51","R05","Z20.828","R94.31","L02.31","U07.1","Z04.9","F31.64","N30.01","E10.42","K31.84","F12.90","B96.20","E87.6","E10.43","Z53.29","S99.912A","S80.912A"," ","F12.188","D50.9","Z16.29","K59.00"],"date":["2021-04-12","2022-12-04","2022-12-02","2022-01-20","2022-02-22","2022-02-22","2022-02-22","2022-12-04","2021-02-17","2021-11-30","2022-12-04","2022-12-04","2021-02-17","2021-05-18","2021-05-18","2020-09-20","2020-09-20","2020-09-20","2021-05-27","2021-05-27","2021-05-27","2021-08-07","2022-10-31","2021-11-30","2020-02-04","2020-02-03","2022-01-01","2020-02-04","2020-06-18","2022-07-12","2022-01-20","2022-01-20","2022-01-20","2022-12-02","2022-01-20","2022-01-01","2022-01-01","2022-06-08","2022-06-08","2021-11-30","2021-11-30","2021-11-30","2022-10-05","2021-11-30","2022-12-02","2021-11-30","2021-11-30","2021-11-30","2022-07-12","2021-05-13","2021-12-02","2020-04-16","2020-09-20","2022-07-12","2022-07-12","2022-07-12","2022-01-20","2020-02-04","2022-07-12","2020-02-25","2020-02-25","2022-07-12","2020-02-25","2022-01-01","2022-01-01","2022-12-04","2021-11-25","2022-06-08","2021-12-01","2020-10-02","2021-11-30","2021-11-30","2022-12-04","2021-02-04","2021-02-04","2021-02-04","2022-12-02","2021-02-04","2021-02-04","2021-11-25","2021-11-25","2021-11-25","2020-06-30","2020-03-14","2022-01-01","2022-06-08","2020-02-18","2021-11-30","2022-10-31","2022-07-12","2022-07-12","2022-07-12","2021-05-28","2022-06-08","2022-01-20","2021-05-18","2022-12-04","2020-12-23","2020-12-23","2020-12-23","2022-01-20","2020-12-07","2022-12-04","2022-02-07","2020-02-11","2020-02-18","2021-11-25","2021-06-17","2021-01-19","2022-10-31","2021-08-07","2021-08-07","2020-04-16","2020-04-16","2020-04-16","2021-05-18","2021-11-30","2022-06-08","2022-11-01","2022-09-28","2022-10-31","2022-10-31","2022-12-04","2022-10-31","2022-12-04","2022-10-31","2022-12-04","2022-12-04","2022-07-12","2022-07-12","2022-12-04","2022-12-02","2022-12-04","2022-12-04","2022-12-04"],"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":[["","61958250101","BIKTARVY","TAB ","30","Select","Select",""],["","42806031250","DOXYCYCL","TAB 100MG","30","Select","Select",""],["","68462018022","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","17478071510","BRIMONIDINE","SOL 0.2% OP","10","Select","Select",""],["","00193731221","CONTOUR","TES NEXT","100","Select","Select",""],["","08484081028","PRODIGY","MIS 28G","100","Select","Select",""],["","59762033302","LATANOPROST","SOL 0.00005","2.5","Select","Select",""],["","00527105001","ACETAZOLAMID","TAB 250MG","120","Select","Select",""],["","61314063136","NEO\/POLY\/DEX","OIN 0.1% OP","3.5","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","24208029505","TOBRA\/DEXAME","SUS 0.3-0.1%","5","Select","Select",""],["","61314063705","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","64980051505","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","73070010315","INSULIN","INJ FLEXPEN","30","Select","Select",""],["","00088221905","LANTUS","INJ 100\/ML","30","Select","Select",""],["","57664037708","TRAMADOL","TAB 50MG","10","Select","Select",""],["","24208048510","DORZOLAMIDE","SOL 2% OP","10","Select","Select",""],["","65862014736","SUMATRIPTAN","TAB 50MG","9","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","7","Select","Select",""],["","49884072703","DOXYCYC","CAP 100MG","20","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","20","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","15","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","20","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":["",""],"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":""}]}]}