{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" L   ANEDREKAMUHS","gend":1,"add":"AM 002TS NI","city":"LOVINGSTON","state":"VA","zip":"22949-9998","dob":"1969-09-18","age":"","mstatus":"","insh":"04000910*619","cliId":"","pno":"62\/4344378-3","cno":"434\/882-4508","email":"","ename":"","eno":"","pphy":"RUCKER, TINSLEY W MD","ppno":"434\/361-2555","pcpadd":"2871 ROCKFISH VALLEY HWY","pcpcity":"NELLYSFORD","pcpstate":"VA","pcpzip":22958,"pcpcounty":"","pcpid":"","pcpname":"UNIVERSITY OF VIRGINIA PHYSICIANS GROUP","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L30.4","G80.0","R25.2","Z99.3","Z00.00","F20.9","G43.909","Z30.8","N94.89","D22.5","E87.6","R60.0","E66.9","Z68.36","Z87.440","Z12.11","Z12.31","R09.81","R52.","R51.9","K59.00","Z12.12","D23.62","L03.116","T14.8XXA","L98.499","D12.2","D12.4","D12.5","D12.3","R19.5","D12.6","L82.1","Z12.83","D48.9","L90.5","D22.9","D23.9","Z23.","U07.1","B34.9","R39.81","L30.9","E66.09","Z79.899"],"date":["2022-03-22","2022-04-14","2021-10-22","2022-04-14","2022-04-14","2022-04-14","2021-07-27","2022-04-06","2022-04-14","2021-11-08","2021-03-26","2022-04-14","2022-04-14","2022-04-14","2021-03-26","2021-11-23","2022-04-14","2021-03-26","2021-03-26","2021-03-26","2022-04-14","2021-03-26","2021-06-09","2021-01-26","2021-03-26","2021-07-21","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2022-04-14","2021-06-09","2021-06-09","2021-06-09","2021-11-08","2021-11-08","2021-06-09","2021-10-29","2022-01-28","2022-01-28","2022-04-14","2022-04-14","2022-04-14","2022-04-14"],"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":[["","27241000550","RISPERIDONE","TAB 3MG","30","Select","Select",""],["","00115101203","BACLOFEN","TAB 20MG","90","Select","Select",""],["","57896050410","ONE-DAILY MULTI VITAMINS","TAB MULT VIT","31","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","62037099905","POTASSIUM CHLORIDE ER","TAB 20MEQ ER","31","Select","Select",""],["","07610015540","MELATONIN","TAB 5MG","31","Select","Select",""],["","68382014005","TOPIRAMATE","TAB 100MG","93","Select","Select",""],["","57896050110","ONE-DAILY MULTI-VITAMIN","TAB MULT-VIT","30","Select","Select",""],["","67877031901","IBUPROFEN","TAB 400MG","30","Select","Select",""],["","75834017002","ZINC OXIDE","OIN 0.2","113","Select","Select",""],["","49348014370","SM CLEARLAX","POW ","238","Select","Select",""],["","00904772524","ANTI-DIARRHEAL","TAB 2MG","20","Select","Select",""],["","16714089803","LORATADINE","TAB 10MG","30","Select","Select",""],["","00713028031","BACITRACIN","OIN 500\/GM","28","Select","Select",""],["","57896062912","GERI-LANTA","SUS ","355","Select","Select",""],["","54629077801","DAILY VITE","TAB ","30","Select","Select",""],["","45802043803","HYDROCORTISONE","CRE 0.01","28","Select","Select",""],["","00904001259","ALLERGY","TAB 4MG","30","Select","Select",""],["","51645078609",""," ","31","Select","Select",""],["","65862018730","ONDANSETRON HYDROCHLORIDE","TAB 4MG","20","Select","Select",""],["","35046000068","DAILY-VITAMIN","TAB ","30","Select","Select",""],["","69618002201","CHLORPHENIRAMINE MALEATE","TAB MAL 4MG","30","Select","Select",""],["","45802086802","POLYETHYLENE GLYCOL 3350","POW 3350 NF","238","Select","Select",""],["","00536132710","ACETAMINOPHEN","TAB 325MG","60","Select","Select",""],["","58657050508","GUAIFENESIN\/DEXTROMETHORPHAN HYDROBROMIDE","SYP 100-10\/5","236","Select","Select",""],["","51672128902","NYSTATIN","CRE 100000","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":["",""]}},{"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":""}]}]}