{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"UC YSIADMAHGNINN","gend":1,"add":" RADEC 155DAOR KROF","city":"RICHMOND","state":"VA","zip":"23223-2722","dob":"1959-05-30","age":"","mstatus":"","insh":"10114731","cliId":"","pno":"9940877457","cno":"","email":"","ename":"","eno":"","pphy":"SHEEHAN, MICHAEL DALE","ppno":8042262444,"pcpadd":"4620 S LABURNUM AVE, ","pcpcity":"Henrico","pcpstate":"VA","pcpzip":232312424,"pcpcounty":"","pcpid":"","pcpname":"LABURNUM MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APT 1","add3":"","madd1":"551 CEDAR FORK ROAD","madd2":"APT 1","madd3":"","mcity":"RICHMOND","mstate":"VA","mzip":"23223-2722","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I21.4","I25.119","Z68.34","I51.9","J90","N17.9","N18.32","N17.8","E11.22","I12.9","U07.1","I10","E11.42","Z79.4","E11.65","R06.02","R10.13","K85.90","R94.31","Z68.30","J96.01","R79.89","I25.10","J98.4","J12.82","G93.41","K85.00","E87.2","N18.4","E11.9","I50.33","E11.21","D64.9","M62.838","Z68.32","Z12.31","Z68.31","F17.210","Z79.82","I20.9","E78.5","I25.2","K21.9","M19.041","M19.042","E66.9","Z86.73","D63.1","E78.00","Z95.1","Z01.818","I11.9","Z03.818","Z20.822","I15.9","R06.00","Z79.899","Z87.891","Z87.01","Z95.5","Z12.11","K59.04","K22.2","K59.09","K22.89","M79.642","M79.641","M65.341","J40","R11.2","A41.9","E87.1","E11.51","E87.5","M19.90","J81.0","N17.0","E87.70","Z90.49","R50.9","R05","I42.8","I51.7","R10.9","K85.91","I13.10","R10.32","D12.3","K64.1","K29.30"],"date":["2021-01-27","2021-01-19","2021-01-20","2021-01-19","2021-01-19","2022-01-15","2022-04-07","2022-01-24","2022-04-07","2022-04-07","2022-02-26","2022-05-28","2022-01-21","2022-01-21","2022-01-20","2022-01-20","2022-04-07","2022-04-07","2022-01-20","2022-01-21","2022-01-22","2022-01-22","2022-04-07","2022-01-22","2022-02-26","2022-01-22","2022-01-27","2022-01-24","2022-02-26","2022-01-27","2021-01-27","2022-02-11","2022-02-11","2020-02-27","2020-09-18","2021-04-29","2021-04-29","2020-03-27","2020-08-24","2020-03-27","2022-01-15","2022-04-07","2022-04-07","2020-03-27","2020-03-27","2021-01-16","2020-03-27","2021-05-05","2022-04-07","2022-04-07","2021-04-29","2021-04-29","2021-06-25","2021-10-22","2020-08-24","2020-08-24","2020-08-24","2022-04-07","2020-08-24","2022-04-07","2022-04-07","2022-03-02","2021-10-29","2021-10-29","2021-10-29","2020-12-03","2020-12-03","2020-12-03","2022-01-13","2022-01-15","2022-01-15","2022-01-15","2022-02-26","2022-01-15","2022-04-07","2021-01-17","2021-01-16","2021-01-16","2021-01-16","2021-01-16","2021-01-16","2021-01-18","2021-01-18","2022-01-18","2022-02-26","2022-02-26","2022-03-02","2022-04-07","2022-04-07","2022-04-07"],"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":[["","00088221905","LANTUS","INJ 100\/ML","12","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","1.5","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","90","Select","Select",""],["","68382076010","METFORMIN","TAB 1000MG","225","Select","Select",""],["","59762330403","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","68180037703","LOSARTAN","TAB 50MG","30","Select","Select",""],["","69315011710","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","00228212910","CLONIDINE","TAB 0.3MG","180","Select","Select",""],["","68462029855","CLOTRIM\/BETA","CRE DIPROP","45","Select","Select",""],["","67877019905","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00186077760","BRILINTA","TAB 90MG","60","Select","Select",""],["","68382065005","ISOSORB","TAB 30MG ER","30","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","2","Select","Select",""],["","42423027101","ALCOHOL","PAD MED 70%","100","Select","Select",""],["","00378001805","METOPROL","TAB 25MG","60","Select","Select",""],["","67877049005","EZETIMIBE","TAB 10MG","30","Select","Select",""],["","70377003012","ATORVASTATIN","TAB 80MG","90","Select","Select",""],["","52268001201","SUPREP","SOL PREP KIT","354","Select","Select",""],["","10702025350","BUT\/APAP\/CAF","TAB ","40","Select","Select",""],["","13107008405","LORAZEPAM","TAB 1MG","30","Select","Select",""],["","00832532510","POT  CL MICRO","TAB 20MEQ ER","30","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","90","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","40.00","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","15.00","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","1.00","Select","Select",""],["","67877054360","CEFDINIR","CAP 300MG","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":""}]}]}