{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ATINAEROOM","gend":1,"add":"            ENAL NNYL 112                         ","city":"WAYNESBORO               ","state":"VA","zip":"22980-5415","dob":"1955-11-02","age":"","mstatus":"","insh":"10114685","cliId":"","pno":"7404595261","cno":5404471372,"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":"N","ano":"","add2":"                                                  ","add3":"","madd1":"211 LYNN LANE                                     ","madd2":"                                                  ","madd3":"","mcity":"WAYNESBORO               ","mstate":"VA","mzip":"22980-5415","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N39.0","R31.9","J44.9","E03.9","R06.83","E11.21","E55.9","G89.4","F15.10","F25.0","K52.9","F19.19","Z11.59","F32.9","R45.851","R30.0","M25.552","E11.9","E78.00","L29.9","L73.9","F32.A","F60.3","F41.1","M79.7","I10","E78.5","Z20.822","Z59.0","Z88.0","Z88.1","Z88.5","F23","F25.9","F17.210","R51.9","R11.0","M25.512","W19.XXXA","S49.92XA","S79.912A","M16.12","R60.9","R73.03","K21.9","F31.9","F20.9","E07.9","Z72.0","Z71.6","Z79.51","Z79.899","M70.62","M54.16","B37.3","Z23","Z12.31","N61.0","T63.94XA","F41.9","R44.0","F15.20","J30.2","W01.0XXA","L98.9","T63.301A","R21","L30.9","Z59.00","R19.4","M54.50","M47.816","H52.4","Z01.419"],"date":["2022-01-25","2022-01-25","2022-01-25","2022-01-25","2022-01-25","2022-01-25","2022-01-25","2022-01-25","2022-01-25","2022-07-25","2021-04-26","2021-07-21","2021-07-21","2021-07-21","2021-07-22","2021-07-26","2021-09-14","2021-12-23","2021-09-14","2021-09-14","2021-08-30","2021-10-05","2021-07-22","2021-07-22","2021-07-22","2021-12-29","2021-10-05","2021-07-22","2021-07-22","2021-12-29","2021-12-29","2021-12-29","2021-03-26","2021-12-29","2021-03-27","2021-07-21","2021-07-21","2021-08-20","2021-08-20","2021-08-20","2021-08-20","2021-09-14","2021-10-25","2021-03-27","2021-04-01","2021-12-29","2021-08-30","2021-10-05","2021-12-29","2021-07-21","2021-08-30","2021-12-29","2021-12-16","2021-12-28","2021-09-30","2021-09-30","2021-09-30","2021-12-29","2021-08-30","2021-12-29","2021-03-26","2021-03-27","2021-03-27","2021-08-20","2021-08-30","2021-08-30","2021-08-30","2021-08-30","2021-10-05","2021-12-23","2021-12-16","2021-12-23","2022-03-31","2021-12-08"],"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":[["","72305005030","EUTHYROX","TAB 50MCG","30","Select","Select",""],["","65162028303","PALIPERIDONE","TAB ER 9MG","7","Select","Select",""],["","60505024801","MIRTAZAPINE","TAB 30MG","7","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","67877021560","CEFUROXIME","TAB 250MG","6","Select","Select",""],["","57237001930","DULOXETINE","CAP 60MG","7","Select","Select",""],["","00093005405","BUSPIRONE","TAB 10MG","14","Select","Select",""],["","70710112307","DOXYCYC","TAB 100MG","14","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","45","Select","Select",""],["","68382011614","RISPERIDONE","TAB 3MG","11","Select","Select",""],["","68645055054","LISINOPRIL","TAB 2.5MG","90","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10.2","Select","Select",""],["","00093505998","ATORVASTATIN","TAB 20MG","90","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","67877031901","IBUPROFEN","TAB 400MG","21","Select","Select",""],["","51672129803","KETOCONAZOLE","CRE 0.02","60","Select","Select",""],["","45802005536","TRIAMCINOLON","OIN 0.001","80","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","31722070090","LOSARTAN","TAB 25MG","30.00","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8.50","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","14.00","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":""}]}]}