{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WILLIAM C PLUMB","gend":0,"add":"410 BIRCHSIDE CIR ","city":"LOCUST GROVE","state":"VA","zip":"22508-9998","dob":"1944-10-15","age":"","mstatus":"","insh":11000305,"cliId":"6E09TJ7PP29","pno":5404069682,"cno":5404069682,"email":"","ename":"","eno":"","pphy":"BABAR, AHMAD","ppno":7037069897,"pcpadd":"4376 Germanna Hwy","pcpcity":"Locust Grove","pcpstate":"VA","pcpzip":225082008,"pcpcounty":"","pcpid":"P0110933","pcpname":"UVA PRIMARY CARE LOCUST GROVE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"410 BIRCHSIDE CIR ","madd2":"","madd3":"","mcity":"LOCUST GROVE","mstate":"VA","mzip":"22508-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["J44.9","R00.0","I10","E11.9","E78.5","F17.200","Z79.899","Z79.51","Z91.018","Z88.8","R68.89","K59.00","R73.03","Z87.19","N20.0","E78.00","K56.609","Z90.49","J06.9","R42","R06.02","R05","R53.81","Z99.81","J98.4","J43.9","R91.8","J44.1","J96.21","F41.9","G47.00","F17.210","I47.1","J41.0","A41.9","J96.22","J15.0","J44.0","Z91.81","J18.9","J90","J98.11","L89.211","J96.10","Z87.01","J18.1","L89.210","L89.219","R53.1","Z87.891","R91.1","R51","R53.83","G47.09","F41.1","R60.0","J41.8","E78.2","T42.4X5A","T42.4X1A","R06.09","Z11.59","Z03.818","D72.829","R73.01","J01.01","R50.9","J30.9","Z12.5","M62.81","K57.32","R10.30","N40.0","R25.1","T88.59XS","Z23","K57.92","K59.01","E87.5","M54.5","J01.80","B97.89","R09.89","K56.600","K56.699","Z46.59","R10.9","R93.3","K56.690","K56.50","K55.019","J96.11","Z91.048","E86.0","K63.89","Z46.82","R07.9","Z86.79","R19.7","K59.8","Z45.2","J96.00","K65.1","G89.18","N17.9","K52.89","R00.2","R09.02","E87.70","Z48.815","J81.1","Z66","R41.0","R20.2","R20.0","R26.2","F41.8","R53.82","J32.9","R00.1","J41.1","R11.0","H54.61","R41.82","R65.20","J96.01","A49.9","K76.9","J34.89","J96.02","J16.8","Z20.822","G93.40","E87.0","J96.91","R55","Z51.5","R45.1","Y73.8","N39.0","T83.511A","J69.0","I50.33","I13.0","F05","Z16.11","R40.4","J43.2","D64.9","R06.00","B96.5","R33.9","Z79.2","G47.9","R13.10","R41.3","Z43.6","F51.04","Z46.6","L89.212","Z99.3"],"date":["2021-11-06","2020-01-03","2021-11-06","2021-10-26","2020-01-13","2020-06-16","2021-07-13","2021-07-13","2021-07-13","2021-07-13","2021-08-15","2021-09-03","2021-08-15","2020-01-13","2021-09-13","2021-08-15","2020-01-13","2020-11-01","2019-01-26","2021-03-25","2021-09-03","2021-07-13","2021-10-20","2021-11-06","2021-09-13","2019-12-14","2021-07-13","2021-10-07","2021-11-06","2021-11-06","2021-11-06","2019-12-26","2021-10-20","2020-11-25","2021-09-15","2021-09-03","2019-02-02","2019-03-07","2021-11-06","2021-10-20","2021-09-13","2021-09-13","2019-02-08","2019-02-08","2019-02-08","2021-09-13","2019-03-07","2019-03-07","2021-07-13","2021-11-06","2021-09-13","2020-06-16","2021-08-15","2021-02-03","2021-10-20","2021-07-13","2018-04-12","2021-11-06","2020-06-07","2020-06-07","2020-06-16","2020-06-16","2020-06-16","2019-06-20","2019-10-04","2020-07-02","2020-07-02","2020-07-02","2020-07-22","2021-11-06","2018-09-04","2018-12-07","2018-09-04","2019-09-09","2019-09-09","2020-10-16","2018-09-20","2018-09-20","2019-10-15","2019-10-10","2020-11-01","2020-11-01","2019-11-07","2018-12-07","2018-12-23","2018-12-12","2018-12-12","2018-12-07","2018-12-15","2018-12-12","2018-12-12","2018-12-21","2021-07-13","2018-12-12","2018-12-23","2021-08-19","2019-12-14","2019-12-14","2019-12-14","2018-12-16","2021-09-13","2021-09-13","2018-12-17","2018-12-20","2021-09-11","2018-12-17","2019-12-18","2021-09-10","2018-12-21","2018-12-23","2018-12-21","2021-09-15","2021-08-28","2019-12-23","2019-12-23","2021-11-06","2019-12-26","2021-08-15","2020-11-01","2021-03-10","2021-03-10","2021-03-25","2021-08-15","2021-09-15","2021-09-03","2021-09-13","2021-09-03","2021-08-19","2021-09-13","2021-09-13","2021-08-19","2021-09-15","2021-09-03","2021-08-28","2021-09-13","2021-08-20","2021-09-15","2021-08-23","2021-08-19","2021-09-16","2021-08-19","2021-11-06","2021-08-19","2021-08-19","2021-08-19","2021-08-19","2021-08-19","2021-09-07","2021-09-11","2021-09-10","2021-09-16","2021-09-13","2021-09-23","2021-08-15","2021-09-03","2021-10-20","2021-10-07","2021-10-20","2021-11-06","2021-11-06","2021-11-06"],"priorHcc":[null,"",null,"","","","","","","","","","","","","","","","","","","","",null,"","","","",null,null,null,"","","","","","","",null,"","","","","","","","","","",null,"","","","","","","",null,"","","","","","","","","","","",null,"","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",null,"","","","","","","","","","","","","","","","","","","","","","","","","",null,"","","","","","","","","","","","","","","","",null,null,null]}},{"a":[]}]},{"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":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","173069600","ADVAIR DISKU","AER 250\/50","","Select","Select",""],["","68682099898","DILTIAZEM","CAP 300MG ER","","Select","Select",""],["","378064110","PREDNISONE","TAB 10MG","","Select","Select",""],["","68180016006","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","67253090150","ALPRAZOLAM","TAB 0.5MG","","Select","Select",""],["","50111044101","TRAZODONE","TAB 150MG","","Select","Select",""],["","70377002711","ATORVASTATIN","TAB 10MG","","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","","Select","Select",""],["","378967130","IPRATROPIUM\/","SOL ALBUTER","","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","","Select","Select",""],["","24658031205","DOXYCYCL HYC","TAB 100MG","","Select","Select",""],["","68180030260","CEFUROXIME","TAB 250MG","","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","","Select","Select",""],["","173069600","ADVAIR ","AER 250\/50","180","Select","Select",""],["","50111044101","TRAZODONE ","TAB 150MG","30","Select","Select",""],["","378395077","ATORVASTATIN ","TAB 10MG","45","Select","Select",""],["","68682099898","DILTIAZEM ","CAP 300MG ER","90","Select","Select",""],["","68180098103","LISINOPRIL ","TAB 20MG","90","Select","Select",""],["","67253090150","ALPRAZOLAM ","TAB 0.5MG","30","Select","Select",""],["","378064110","PREDNISONE ","TAB 10MG","6","Select","Select",""],["","68180016006","AZITHROMYCIN ","TAB 250MG","4","Select","Select",""],["","68382091634","METHYLPRED ","TAB 4MG","21","Select","Select",""],["","378967130","IPRATROPIUM\/ ","SOL ALBUTER","90","Select","Select",""],["","65862053750","LEVOFLOXACIN ","TAB 500MG","10","Select","Select",""],["","65862001501","AMOXICILLIN ","TAB 875MG","14","Select","Select",""],["","68180030360","CEFUROXIME ","TAB 500MG","20","Select","Select",""],["","24658031205","DOXYCYCL ","TAB 100MG","20","Select","Select",""],["","00173069600","ADVAIR","250\/50","180","Select","Select",""],["","24658031205","DOXYCYCL","100MG","20","Select","Select",""],["","65862049101","QUETIAPINE","100MG","60","Select","Select",""],["","00378021610","FUROSEMIDE","40MG","60","Select","Select",""],["","00093406106","FORMOTEROL","20\/2ML","120","Select","Select",""],["","00115168774","BUDESONIDE","0.25MG\/2","60","Select","Select",""],["","60505614700","CEFEPIME","2GM","8","Select","Select",""],["","69097083412","SERTRALINE","50MG","30","Select","Select",""],["","65862049101","QUETIAPINE ","TAB 100MG","60","Select","Select",""],["","00378021610","FUROSEMIDE ","TAB 40MG","60","Select","Select",""],["","00093406106","FORMOTEROL ","NEB 20\/2ML","120","Select","Select",""],["","60505614700","CEFEPIME ","INJ 2GM","8","Select","Select",""],["","69097083412","SERTRALINE ","TAB 50MG","30","Select","Select",""],["","00115168774","BUDESONIDE ","SUS 0.25MG\/2","60","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}