{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"N YELHSARETRAC ","gend":1,"add":"     ENAL ETNIOPHTRON 002                         ","city":"DANVILLE                 ","state":"VA","zip":"24540-9998","dob":"1989-06-30","age":"","mstatus":"","insh":"10115955","cliId":"","pno":"1743458513","cno":"","email":"","ename":"","eno":"","pphy":"BRIDGES, STEVEN D","ppno":4347972828,"pcpadd":"723 PINEY FOREST RD,","pcpcity":"Danville","pcpstate":"VA","pcpzip":245402860,"pcpcounty":"","pcpid":"","pcpname":"FAMILY HEALTHCARE CENTER OF DANVILLE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"APT 304                                           ","add3":"","madd1":"200 NORTHPOINTE LANE                              ","madd2":"APT 304                                           ","madd3":"","mcity":"DANVILLE                 ","mstate":"VA","mzip":"24540-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.84","D57.80","D57.1","Z88.5","Z79.891","D57.00","R11.2","E87.2","E87.8","G89.4","M54.50","D72.829","Z83.2","M54.5","E83.111","F11.90","Z79.899","D57.819","M54.9","G89.29","M62.838","D64.9","M54.6","M62.830","R11.0","J45.909","R10.9","R51.9","G25.81","Z88.6","E80.7","E80.6","O99.013","K80.20","E83.119","K80.80","R10.11","R74.01","N39.0","Z82.79","M54.89","Z91.14","M45.5","Z32.02","R10.32","Z88.8","R42","N83.02","R11.10","E87.1","E83.10","R91.8","R05","D72.820","H10.32","H57.12","H10.023","H10.89","H57.13","H53.8","E58","M53.3","R53.1","K80.00","D57.818","R31.9","Z76.5","K81.9","R17","K66.0","K80.60","F17.200","D57.219","R07.9","R06.02","R06.89","Z90.49","Z98.51","R10.819","R94.31","Z20.822","E87.6","Z79.1","Z53.29","R53.81","U07.1","I70.0","R01.1","R93.41","R16.0","E83.19","K52.9","R19.7","R68.89","R10.10","R52","G57.00","R82.71","Z72.0"," ","Z86.2","T23.261A","T23.201A","X10.2XXA","Y93.G3"],"date":["2022-09-18","2022-11-13","2022-12-03","2022-11-13","2022-11-06","2022-12-03","2022-10-12","2022-01-03","2022-01-03","2022-12-03","2022-12-03","2022-07-29","2022-08-16","2021-09-24","2022-07-19","2022-10-20","2022-07-19","2022-11-10","2022-11-10","2022-12-03","2021-01-22","2022-10-09","2022-08-25","2021-01-22","2022-10-09","2022-02-06","2022-11-10","2022-07-15","2021-09-24","2022-10-14","2022-12-03","2022-10-20","2021-04-12","2021-11-15","2021-04-13","2021-11-18","2021-08-28","2022-12-03","2022-07-29","2021-05-14","2021-07-15","2021-11-12","2021-07-14","2021-08-24","2021-08-09","2022-11-13","2021-08-16","2021-08-17","2021-08-17","2021-08-30","2021-08-28","2021-08-28","2021-08-28","2021-08-29","2020-09-01","2020-09-01","2020-09-05","2020-09-05","2020-09-05","2020-09-05","2020-09-21","2021-10-07","2022-08-16","2021-11-12","2021-11-12","2021-11-12","2021-11-12","2021-11-15","2022-10-12","2021-11-15","2021-11-15","2020-12-09","2022-07-15","2022-06-29","2022-10-12","2022-03-25","2022-10-14","2022-03-28","2021-04-13","2021-11-10","2022-10-13","2022-06-01","2022-06-05","2022-05-17","2022-11-13","2022-07-16","2022-07-29","2022-08-16","2022-08-27","2022-08-27","2021-08-30","2022-08-27","2022-08-27","2022-08-16","2022-08-25","2022-08-27","2022-08-15","2022-10-16","2022-10-12","2022-12-03","2022-11-06","2022-11-08","2022-11-08","2022-11-08","2022-11-08"],"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":[["","43386035701","HYDROCO\/APAP","TAB 7.5-325","10","Select","Select",""],["","00832105410","BACLOFEN","TAB 10MG","30","Select","Select",""],["","71093014005","METHOCARBAM","TAB 500MG","56","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","15","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","49884072401","HYDROXYUREA","CAP 500MG","15","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","20","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","30","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","4","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","60505384901","CELECOXIB","CAP 200MG","7.00","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","30.00","Select","Select",""],["","42858030101","HYDROMORPHON","TAB 2MG","30.00","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":["",""]}},{"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":""}]}]}