{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" W NALARELPEH","gend":0,"add":"RTS YAG 045501 TPA TEE","city":"Danville","state":"VA","zip":"24541-9998","dob":"1975-04-10","age":"","mstatus":"","insh":"10117272","cliId":"","pno":"8643462688","cno":"","email":"","ename":"","eno":"","pphy":"SMITH, DAVID B","ppno":4347992225,"pcpadd":"159 EXECUTIVE DR,","pcpcity":"DANVILLE","pcpstate":"VA","pcpzip":"24541-9998","pcpcounty":"","pcpid":"","pcpname":"DANVILLE PHYSICIAN PRACTICES LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"APT 105","add3":"","madd1":"540 GAY STREET APT 105","madd2":"APT 105","madd3":"","mcity":"Danville","mstate":"VA","mzip":"24541-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J96.12","J96.22","J44.1","I50.32","E66.2","Z68.42","J96.21","I11.0","E11.9","Z20.822","G47.33","R06.00","J44.9","Z09","I50.33","J96.01","J18.9","I10","E78.2","F79","Z68.43","J96.02","E11.65","R06.02","I50.30","J81.1","J96.00","D64.9","E78.5","I27.20","Z99.81","Z79.84","Z01.810","Z01.812","Z01.89","I44.7","E87.70","K92.1","D50.9","D12.0","D12.3","D36.10","G47.30","K21.9","E66.01","Z13.29","R07.9","L84","R60.0","R06.09","Z99.11","R09.02","J96.10","E61.1","Z91.030","Z87.01","J30.1","Z23","J96.11","I50.9","R21","R80.9","R60.9","R06.2","E08.40","B35.1","I70.90","R06.89","R06.83","Z99.89","R26.2","D12.6","R42","R31.9","I87.2","M54.5","M53.3","Z12.5","L60.3","E11.29","R80.1","B35.3","B35.6","R05.1","G31.84","R71.8","M79.18","K63.5","J98.4","R07.89","L24.9","L71.9","K08.9","K06.1","H53.032","H52.4","J22","T63.441A","S61.042A","X58.XXXA","M79.645","Z74.01","K42.9","L20.9","R93.89","I45.4","R00.0","R45.0"],"date":["2023-07-25","2021-12-10","2021-12-10","2023-07-20","2023-07-20","2022-10-21","2022-01-06","2021-12-10","2023-06-09","2022-10-17","2023-05-30","2023-07-20","2023-07-25","2021-12-21","2021-04-30","2021-12-14","2023-02-13","2023-07-20","2023-07-20","2023-06-16","2023-01-27","2021-12-15","2021-12-21","2022-02-18","2021-04-23","2021-04-23","2021-12-09","2021-12-09","2021-12-09","2021-12-09","2022-11-04","2022-10-21","2022-10-17","2022-10-17","2022-10-17","2023-07-20","2021-12-14","2022-10-21","2022-11-04","2022-10-21","2022-10-21","2022-10-21","2022-10-21","2022-10-21","2023-06-16","2022-02-18","2021-06-24","2021-06-24","2023-07-20","2023-01-04","2023-05-18","2021-12-09","2023-01-27","2022-04-20","2022-10-21","2022-01-06","2022-01-06","2023-01-04","2023-07-20","2023-01-04","2022-11-17","2022-04-20","2021-05-14","2021-05-14","2023-05-24","2023-05-24","2023-05-24","2022-07-06","2022-09-01","2021-05-06","2023-05-24","2022-11-04","2022-12-05","2022-12-05","2021-04-21","2020-10-12","2020-10-12","2023-01-31","2022-11-02","2022-09-29","2022-09-29","2020-08-05","2023-05-02","2023-03-22","2021-06-04","2021-10-12","2020-10-05","2022-10-21","2021-04-30","2023-02-07","2023-06-28","2023-06-28","2023-01-27","2023-01-27","2022-09-22","2022-09-22","2023-03-10","2023-04-13","2023-04-13","2023-04-13","2023-04-13","2023-04-13","2023-06-16","2023-06-28","2023-07-20","2023-04-13","2023-04-13","2023-04-13"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":[["","69315030660","NYSTATIN","POW 100000","60","Select","Select",""],["","67405060301","FLUCONAZOLE","TAB 150MG","4","Select","Select",""],["","00168009930","KETOCONAZOLE","CRE 0.02","60","Select","Select",""],["","29300039810","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","00172572880","FAMOTIDINE","TAB 20MG","180","Select","Select",""],["","16729028417","ROSUVASTATIN","TAB 5MG","30","Select","Select",""],["","00487020160","IPRATROPIUM\/","SOL ALBUTER","360","Select","Select",""],["","51224002070","METFORMIN","TAB 500MG","180","Select","Select",""],["","31722070210","LOSARTAN POT","TAB 100MG","90","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8.5","Select","Select",""],["","69315011710","FUROSEMIDE","TAB 40MG","90","Select","Select",""],["","55111046901","METOPROL SUC","TAB 200MG ER","30","Select","Select",""],["","00006057761","JANUMET","TAB 50-1000","60","Select","Select",""],["","64380076921","PEG-3350\/KCL","SOL \/SODIUM","4000","Select","Select",""],["","59746017310","PREDNISONE","TAB 10MG","14","Select","Select",""],["","56151014701","TRUPLUS LANC","MIS 33G","100","Select","Select",""],["","56151146304","TRUE METRIX","TES GLUCOSE","100","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","57664050652","METOPROL TAR","TAB 25MG","180","Select","Select",""],["","59762219803","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","31722070210","LOSARTAN","TAB 100MG","90","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","57664050652","METOPROL","TAB 25MG","180","Select","Select",""],["","56151014701","TRUPLUS","MIS 33G","100","Select","Select",""],["","56151146304","TRUE","TES GLUCOSE","100","Select","Select",""],["","29300039810","AMLODIPINE TAB","10MG","30","Select","Select",""],["","00487020160","IPRATROPIUM\/ SOL ALBUTER","","360","Select","Select",""],["","16729028417","ROSUVASTATIN TAB","5MG","30","Select","Select",""],["","51224002070","METFORMIN TAB","500MG","180","Select","Select",""],["","59310057922","PROAIR HFA AER","","8.5","Select","Select",""],["","69315011710","FUROSEMIDE TAB","40MG","90","Select","Select",""],["","55111046901","METOPROL SUC TAB","200MG ER","30","Select","Select",""],["","00006057761","JANUMET TAB","50-1000","60","Select","Select",""],["","64380076921","PEG-","3350\/KCL SOL \/SODIUM","4000","Select","Select",""],["","59746017310","PREDNISONE TAB","10MG","14","Select","Select",""],["","56151014701","TRUPLUS LANC MIS","33G","100","Select","Select",""],["","56151149002","TRUE METRIX KIT AIR","","1","Select","Select",""],["","56151146304","TRUE METRIX TES GLUCOSE","","100","Select","Select",""],["","66993001968","ALBUTEROL AER HFA","","18","Select","Select",""],["","00172572880","FAMOTIDINE TAB","20MG","180","Select","Select",""],["","29300012810","HYDROCHLOROT TAB","25MG","30","Select","Select",""],["","56151147002","TRUE METRIX KIT METER","","1","Select","Select",""],["","31722070210","LOSARTAN POT TAB","100MG","90","Select","Select",""],["","57664050652","METOPROL TAR TAB","25MG","180","Select","Select",""],["","59762219803","AZITHROMYCIN TAB","250MG","6","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}