{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" H EGROEGRJ SNAVE","gend":0,"add":"          TS REFFAHS 6061                         ","city":"LYNCHBURG                ","state":"VA","zip":"24501-9998","dob":"1959-03-23","age":"","mstatus":"","insh":"10115226","cliId":"","pno":"0443417331","cno":"","email":"","ename":"","eno":"","pphy":"PAGE, TERESA M","ppno":4342003366,"pcpadd":"800 5TH ST,MARTIN LUTHER KING JR BLVD","pcpcity":"Lynchburg","pcpstate":"VA","pcpzip":245042848,"pcpcounty":"","pcpid":"","pcpname":"COMMUNITY ACCESS NETWORK","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"1606 SHAFFER ST                                   ","madd2":"                                                  ","madd3":"","mcity":"LYNCHBURG                ","mstate":"VA","mzip":"24501-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z95.810","Z23","Z51.0","C61","R59.0","I48.91","I11.0","I50.9","J44.9","E11.9","K21.9","K42.9","E78.5","H40.9","Z79.01","Z79.899","Z80.9","E78.2","R05","H40.1132","T85.398S","H27.03","H04.123","J30.89","R53.83","I25.119","I10","I48.20","I50.22","I25.10","Z95.5","I25.2","Z79.82","I42.9","I48.0","I49.3","E78.9","Z87.891","I25.9","Z08","Z92.3","R35.1","N52.9","K59.00","R19.09","Z12.11","Z94.7","R19.5","D64.9","Z71.9","E11.8","R97.20","Z91.89","D12.6","K64.4","K92.1","K63.5","K55.21","Z88.5","J45.909","Z85.46"," "],"date":["2022-12-01","2022-08-25","2020-11-02","2022-08-01","2020-11-02","2022-11-15","2022-04-29","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2020-11-02","2022-11-15","2022-04-29","2022-11-15","2020-12-21","2020-11-02","2022-04-29","2021-09-07","2022-07-06","2021-12-17","2022-07-06","2022-07-06","2022-04-29","2021-03-09","2022-04-29","2022-11-15","2022-08-02","2022-11-15","2022-11-15","2020-12-21","2020-12-21","2020-12-21","2022-11-15","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2021-12-14","2021-12-14","2022-08-01","2022-08-01","2022-08-01","2021-08-25","2022-04-29","2022-07-06","2022-10-27","2022-08-03","2022-08-03","2022-08-02","2022-08-02","2022-08-02","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-10-27","2022-12-01"],"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":[["","00173086910","ANORO","AER 62.5-25","60","Select","Select",""],["","62756016013","TAMSULOSIN","CAP 0.4MG","180","Select","Select",""],["","59762033302","LATANOPROST","SOL 0.00005","7.5","Select","Select",""],["","76204060030","IPRATROPIUM\/","SOL ALBUTER","360","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","24208041105","BRIMONIDINE","SOL 0.2% OP","10","Select","Select",""],["","16729011917","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","68382009401","CARVEDILOL","TAB 12.5MG","90","Select","Select",""],["","70377000911","ROSUVASTATIN","TAB 40MG","90","Select","Select",""],["","00054001729","PREDNISONE","TAB 10MG","21","Select","Select",""],["","51224002218","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","55111064501","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","00078077720","ENTRESTO","TAB 49-51MG","60","Select","Select",""],["","00065027510","AZOPT","SUS 1% OP","10","Select","Select",""],["","24208048510","DORZOLAMIDE","SOL 2% OP","10.00","Select","Select",""],["","23155005701","GLYBURIDE","TAB 2.5MG","90","Select","Select",""],["","69315011710","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","00378395305","ATORVASTATIN","TAB 80MG","90","Select","Select",""],["","00832532510","POT  CL MICRO","TAB 20MEQ ER","30","Select","Select",""],["","00591040501","LISINOPRIL","TAB 2.5MG","90","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00173068220","VENTOLIN","AER ","54","Select","Select",""],["","59310057922","PROAIR","AER ","25.5","Select","Select",""],["","00378827052","ALBUTEROL","NEB 0.00083","150","Select","Select",""],["","43598043501","NITROGLYCERN","SUB 0.3MG","300","Select","Select",""],["","53885092701","ONETOUCH","KIT VERIO RE","1","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":""}]}]}