{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"H EIDDEKCOCNA","gend":0,"add":"   DAOR SKEERC EERHT 1875                         ","city":"GLADYS                   ","state":"VA","zip":"24554-2389","dob":"1956-05-28","age":"","mstatus":"","insh":"10119373","cliId":"","pno":"7343454436","cno":"","email":"","ename":"","eno":"","pphy":"WALDRON, VINCENT JOHN","ppno":4343762325,"pcpadd":"104 CAROLINA AVE,","pcpcity":"Brookneal","pcpstate":"VA","pcpzip":245282643,"pcpcounty":"","pcpid":"","pcpname":"CENTRA HEALTH BROOKNEAL FAMILY MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"5781 THREE CREEKS ROAD                            ","madd2":"                                                  ","madd3":"","mcity":"GLADYS                   ","mstate":"VA","mzip":"24554-2389","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.1","Z20.828","F25.0","M54.9","F31.9","R73.03","E11.9","E78.00","I48.0","Z79.899","K59.09","Z87.891","Z12.5","I48.91","G93.3","K21.9","E78.2","R00.2","K59.04","R07.9","E66.9","Z68.30","E78.5","Z79.01","M25.571","J30.9","H10.13","K21.0","T78.40XA","H04.203","M43.6","Z00.8","R53.82","E83.52","F31.32","J34.89","Z20.822","D72.819","R53.83","H65.31","H65.91","H66.91","K59.00","F31.62","H92.01","R07.89","K52.1","R10.9","R11.10","R19.7","J01.00","I95.9","K57.92","F20.9","M25.532","Z23"," "],"date":["2022-12-08","2022-01-06","2021-03-06","2022-01-27","2022-06-05","2021-08-17","2021-02-16","2022-08-17","2022-05-10","2022-06-16","2021-02-16","2022-10-19","2021-10-27","2022-10-10","2022-02-17","2022-08-17","2022-02-25","2022-05-10","2022-06-22","2022-10-19","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2020-08-26","2021-07-08","2020-07-22","2020-07-27","2020-07-27","2020-07-27","2020-07-27","2020-08-17","2022-02-25","2020-08-25","2021-09-13","2021-09-27","2021-09-27","2020-10-12","2021-10-22","2022-03-16","2022-03-16","2022-04-13","2022-03-24","2022-07-08","2022-04-13","2022-10-06","2022-06-09","2022-06-09","2022-06-09","2022-06-09","2021-09-27","2021-09-27","2021-10-27","2022-06-05","2022-10-13","2022-10-13","2022-12-08"],"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":[["","69315013601","BENZTROPINE","TAB 0.5MG","30","Select","Select",""],["","16729004517","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","49483061850","NAPROXEN","TAB 500MG","60","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30.00","Select","Select",""],["","00781223410","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","29300014001","DIVALPROEX","TAB 500MG DR","90","Select","Select",""],["","63402030230","LATUDA","TAB 20MG","30","Select","Select",""],["","00093227534","AMOX\/K","TAB 875-125","20","Select","Select",""],["","49281012165","FLUZONE","INJ 2021-22","0.7","Select","Select",""],["","69097015915","MELOXICAM","TAB 15MG","30","Select","Select",""],["","50742061510","METOPROL","TAB 25MG ER","30","Select","Select",""],["","50111056102","TRAZODONE","TAB 100MG","30","Select","Select",""],["","45802002683","AZELASTINE","SPR 0.0015","30","Select","Select",""],["","00054001729","PREDNISONE","TAB 10MG","25","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","20.00","Select","Select",""],["","00378668877","PANTOPRAZOLE","TAB 20MG","30","Select","Select",""],["","69452027120","LOPERAMIDE","CAP 2MG","12","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","20.00","Select","Select",""],["","72578000805","METRONIDAZOL","TAB 500MG","21","Select","Select",""],["","55111012705","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","16729011917","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","00254101196","SUCRALFATE","SUS 1GM\/10ML","300","Select","Select",""],["","33332032001","AFLURIA","INJ 2020-21","0.5","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":""}]}]}