{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" V YRAMTREBLOC","gend":1,"add":"           TS SREKCIB 112                         ","city":"CULPEPER                 ","state":"VA","zip":"22701-9998","dob":"1950-09-20","age":"","mstatus":"","insh":"10117392","cliId":"","pno":"7220252146","cno":7573461721,"email":"","ename":"","eno":"","pphy":"PROL, JENNIFER J","ppno":5408256100,"pcpadd":"1200 SUNSET LN STE 2210,STE 101","pcpcity":"Culpeper","pcpstate":"VA","pcpzip":227013376,"pcpcounty":"","pcpid":"","pcpname":"UNIVERSITY OF VIRGINIA PHYSICIANS GROUP","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"211 BICKERS ST                                    ","madd2":"                                                  ","madd3":"","mcity":"CULPEPER                 ","mstate":"VA","mzip":"22701-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F32.9","I51.9","T78.3XXS","R39.81","M62.81","M25.551","R26.89","I89.0","E78.2","Z23","I10","E55.9","Z11.59","Z12.31","M62.838","I11.0","M79.604","M25.559","M79.605","R60.0","M79.89","R93.7","R60.9","M25.572","S82.55XA","X58.XXXA","Y92.9","K21.9","Z96.652","Z79.899","E66.01","Z68.42","S82.892A","Z78.0","F33.1","I87.2","I87.8","S93.491A","G89.29","R22.43","E78.5","Z90.710","Z88.8","M85.852","M85.80","M16.0","S92.812D","S93.491D","R26.2","D64.9","F41.8","R06.02","M16.11","G89.4","M54.41","M54.42","M47.26","M16.9","M26.89","L03.116","M54.50","M54.17","M25.552","R73.9","S81.801A","R53.82","I70.25","N28.9","I73.9"," ","Z53.8","K59.00","Z00.00","R71.0","M16.12"],"date":["2022-11-01","2022-11-01","2022-11-01","2022-11-22","2022-11-22","2022-08-08","2022-02-01","2022-07-12","2022-11-08","2022-02-04","2022-11-08","2022-02-04","2022-02-04","2022-02-08","2020-04-16","2020-07-16","2021-07-30","2021-07-30","2021-08-17","2022-11-08","2021-08-17","2021-08-17","2021-08-17","2021-09-30","2021-08-17","2021-08-26","2021-08-17","2021-12-29","2021-08-26","2021-09-30","2022-11-08","2021-09-30","2021-08-19","2021-09-03","2021-09-21","2021-08-19","2022-08-02","2021-08-26","2022-08-08","2021-08-26","2021-12-29","2021-08-26","2021-08-26","2021-09-03","2021-09-22","2022-09-19","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2021-09-22","2022-09-01","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-01","2021-12-08","2022-03-01","2021-12-29","2022-11-08","2022-05-18","2022-05-05","2022-07-28","2022-08-02","2022-06-28","2022-08-02","2022-11-22","2022-09-19","2022-11-08","2022-08-08","2022-11-08","2022-09-01"],"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":[["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","45802049383","AMMONIUM","CRE 0.12","280.00","Select","Select",""],["","57664050658","METOPROL","TAB 25MG","30","Select","Select",""],["","31722052901","TORSEMIDE","TAB 5MG","30","Select","Select",""],["","68180071909","AMLODIPINE","TAB 2.5MG","90","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","180","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","90","Select","Select",""],["","70377000712","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","51991074790","DULOXETINE","CAP 30MG","30","Select","Select",""],["","60505025203","TIZANIDINE","TAB 4MG","60","Select","Select",""],["","49483060350","IBUPROFEN","TAB 600MG","21","Select","Select",""],["","70436001002","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","70377002711","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","00832105410","BACLOFEN","TAB 10MG","30","Select","Select",""],["","33342032715","TRIAMCINOLON","CRE 0.00025","30","Select","Select",""],["","93101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","180","Select","Select",""],["","68180021509","LOSARTAN\/HCT","TAB 50-12.5","90","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","30","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":""}]}]}