{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARIE WILLIAMS","gend":1,"add":"108 TRAFTON STREET","city":"HENRICO","state":"VA","zip":232222036,"dob":"1940-06-22","age":"","mstatus":"","insh":11002147,"cliId":"3YV8AV1VR28","pno":8043778544,"cno":8042470699,"email":"","ename":"","eno":"","pphy":"GREEN, HAROLD T","ppno":8046441665,"pcpadd":"2421 Chamberlayne Ave","pcpcity":"Richmond","pcpstate":"VA","pcpzip":232224205,"pcpcounty":"","pcpid":"P0149971","pcpname":"PRIMARY HEALTHCARE ASSOCIATES","plan":"VPHP - VIRGINIA PREMIER","program":"Medicare","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["I10","E87.0","M62.81","R13.12","R48.8","G93.40","F03.91","G40.909","I67.9","M10.9","I69.920","F32.9","R39.81","R15.9","F03.90","E04.2","Z86.73","L89.152","L89.610","L89.620","I82.622","Z79.01","R05","L89.616","L89.626","Z86.718","Z86.69","L89.619","L89.629","Z99.3","L60.0","B35.3","B35.1","I73.9","R63.4","R56.9","N39.0","R25.2","I26.99","G40.409","I82.409","R22.32","M19.90","L89.150","M19.041","M19.042","M24.541","M24.542","Z74.01","L98.491","E04.9","E55.9","L89.154","L89.153","I69.398","M62.442","M62.462","M62.461","Z79.02","R22.30","M62.838","Z66","L89.101","Z74.09","I63.9","E04.1","L89.893","G30.0","Z79.899","L89.312","L89.322","L89.159","R62.7","L89.151","G30.9","I82.C12","I82.A12","I82.612","T14.8XXA","I82.B12","M79.81","J98.11","I70.0","I25.10","M79.89","R41.82","R53.1","M62.89","L98.9","F01.50","B36.9","Z87.2"],"date":["2020-03-16","2018-08-01","2018-09-02","2018-09-02","2018-08-01","2018-08-01","2018-08-01","2021-01-21","2018-08-01","2020-10-29","2018-08-01","2021-01-21","2021-06-19","2021-06-19","2021-06-19","2021-01-21","2021-06-02","2021-05-19","2020-08-19","2020-10-08","2020-02-13","2021-06-02","2020-01-22","2020-11-23","2020-11-23","2021-06-02","2020-10-08","2021-01-21","2021-01-21","2019-10-02","2018-05-04","2018-05-04","2018-05-04","2018-05-04","2018-08-01","2021-06-02","2018-05-30","2020-07-28","2020-09-11","2020-10-29","2020-07-28","2020-07-28","2020-07-28","2020-08-30","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-08-04","2019-08-19","2019-09-17","2020-08-19","2020-11-23","2019-10-02","2019-10-02","2019-10-02","2019-10-02","2019-11-20","2020-09-11","2020-09-11","2020-09-11","2019-09-17","2020-01-06","2020-11-23","2019-09-17","2020-10-08","2020-11-25","2018-10-26","2019-10-31","2019-10-31","2021-01-21","2018-11-15","2020-01-06","2018-12-14","2020-01-10","2020-01-06","2020-01-06","2020-01-06","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2020-01-10","2020-01-11","2020-01-11","2020-01-13","2020-01-13","2021-06-10","2021-03-31","2021-03-31"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"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":[["","65862001205","SERTRALINE","TAB 50MG","","Select","Select",""],["","50383024116","LEVETIRACETA","SOL 100MG\/ML","","Select","Select",""],["","574200830","NYSTOP","POW 100000","","Select","Select",""],["","781730931","RIVASTIGMINE","DIS 9.5MG\/24","","Select","Select",""],["","3089421","ELIQUIS","TAB 5MG","","Select","Select",""],["","16729021816","CLOPIDOGREL","TAB 75MG","","Select","Select",""],["","3376474","ELIQUIS ST P","TAB 5MG","","Select","Select",""],["","62332041510","OSELTAMIVIR","CAP 75MG","","Select","Select",""],["","3089421","ELIQUIS ","TAB 5MG","60","Select","Select",""],["","62332041510","OSELTAMIVIR ","CAP 75MG","10","Select","Select",""],["","60505025303","CLOPIDOGREL ","TAB 75MG","30","Select","Select",""],["","65862001205","SERTRALINE ","TAB 50MG","30","Select","Select",""],["","50383024116","LEVETIRACETA ","SOL 100MG\/ML","450","Select","Select",""],["","781730931","RIVASTIGMINE ","DIS 9.5MG\/24","90","Select","Select",""],["","574200830","NYSTOP ","POW 100000","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":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","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":""}]}]}