{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GEORGIA D POWELL","gend":1,"add":"1176 MILL RD","city":"EMPORIA  ","state":"VA","zip":"23847-9998","dob":"1963-09-21","age":"","mstatus":"","insh":11002403,"cliId":"8EG5MY8TJ71","pno":4346345396,"cno":4346345396,"email":"","ename":"","eno":"","pphy":"PINSON, ANDY G ","ppno":8048288786,"pcpadd":"417 N 11th St","pcpcity":"Richmond ","pcpstate":"VA","pcpzip":232985002,"pcpcounty":"","pcpid":"P9059171","pcpname":"VCUHS AD WILLIAMS CLINIC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1176 MILL RD","madd2":"","madd3":"","mcity":"EMPORIA  ","mstate":"VA","mzip":"23847-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["M79.609","I83.813","I87.2","I83.812","I83.892","K59.00","E66.9","Z68.42","I83.893","Z30.42","J45.909","Z79.52","M06.9","J30.9","Z79.899","F32.0","F41.9","M15.9","M77.01","F32.9","R06.00","R05","R06.02","M13.0","R79.89","M25.512","M19.012","I10","E66.01","M77.12","M17.12","J45.20","Z32.02","L21.8","L29.8","L67.0","F33.3","K21.9","I05.9","I34.1","J34.89","J01.00","Z71.3","M79.89","R22.42","J45.901","Z20.828","J98.4","R07.9","U07.1","J12.89","E86.0","N39.0","R09.02","M19.90","D72.819","Z87.09","Z86.19","R11.10","Z76.89","N93.8","N95.0","N92.0","N92.6","Z68.32","Z01.818","N93.9","D64.9","N94.89","Z23","R09.81","F33.1","R73.03","M54.31","M54.16","M41.9","R26.89","N95.1","L24.9","M77.10","M17.10","M54.5","J01.90","M25.562","M47.26","R25.2","M54.41","R09.82","Z01.419","I83.891","I83.811","Z12.31","G62.9","Z01.411","N60.01","N63.10","H25.13","H35.013","H35.89","Z11.51","Z20.822","Z86.16","E11.42","E11.69","H26.9","F33.9","M17.0","M16.0","R26.81","N85.00","M25.561","H02.831","M54.9","R53.1","R60.0","R53.81","M25.662","Z68.43","S89.91XA","M79.604","S80.11XA","W19.XXXA","M79.605","R05.3","F32.A","R05.9"],"date":["2020-03-31","2020-07-21","2020-07-21","2019-03-28","2019-03-28","2020-10-28","2021-11-08","2021-02-04","2020-07-21","2020-05-22","2021-01-27","2020-02-13","2020-02-13","2020-05-05","2021-01-13","2020-05-06","2020-05-06","2018-05-09","2020-02-12","2021-07-14","2020-08-08","2021-08-11","2020-06-15","2020-09-30","2019-05-13","2019-08-07","2019-08-21","2021-08-22","2021-08-02","2020-02-12","2021-10-27","2020-09-30","2020-05-22","2019-05-24","2019-05-24","2019-05-24","2019-11-30","2021-08-11","2020-06-15","2020-08-12","2020-06-16","2019-06-21","2019-07-09","2020-07-10","2020-07-10","2021-11-08","2020-08-03","2020-08-08","2020-08-08","2020-08-20","2020-08-10","2020-08-10","2020-08-09","2020-08-08","2020-08-12","2020-08-10","2020-08-10","2020-08-12","2018-08-16","2020-08-20","2020-09-17","2021-08-11","2018-09-26","2018-10-03","2020-09-30","2018-10-08","2019-01-23","2018-10-15","2018-10-15","2018-11-07","2021-01-27","2021-10-27","2018-11-28","2019-12-04","2020-02-13","2019-12-04","2021-08-02","2019-12-10","2018-12-31","2018-12-19","2018-12-26","2020-02-12","2020-02-04","2021-08-02","2018-02-08","2020-02-08","2020-02-12","2020-02-12","2018-02-13","2019-03-01","2019-03-01","2021-03-31","2018-02-21","2020-12-24","2018-03-06","2018-03-06","2021-06-21","2021-06-21","2021-06-21","2020-12-24","2021-11-08","2021-10-27","2020-02-13","2020-02-13","2020-02-13","2020-02-13","2020-02-13","2020-02-13","2020-02-13","2021-06-02","2021-08-22","2021-06-21","2021-07-14","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-11-08","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2021-10-27","2021-10-27","2021-10-27","2021-11-08"],"priorHcc":["","","","","","",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":[["","70710122600","AMITRIPTYLIN","TAB 25MG","","Select","Select",""],["","59762453701","MEDROXYPR AC","INJ 150MG\/ML","","Select","Select",""],["","62175013643","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","93742698","MONTELUKAST","TAB 10MG","","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","","Select","Select",""],["","173069600","ADVAIR DISKU","AER 250\/50","","Select","Select",""],["","50111064801","FLUOXETINE","CAP 20MG","","Select","Select",""],["","47781030801","NITROFUR MAC","CAP 100MG","","Select","Select",""],["","378827052","ALBUTEROL","NEB 0.00083","","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","","Select","Select",""],["","68180016006","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","","Select","Select",""],["","54327099","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","65862050320","AMOX\/K CLAV","TAB 875-125","","Select","Select",""],["","43547040510","METHOCARBAM","TAB 500MG","","Select","Select",""],["","54001829","PREDNISONE","TAB 20MG","","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","","Select","Select",""],["","93310905","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","","Select","Select",""],["","406012305","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","93206406","CILOSTAZOL","TAB 100MG","","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","59310057922","PROAIR ","AER ","17","Select","Select",""],["","62175013643","OMEPRAZOLE ","CAP 40MG","30","Select","Select",""],["","173069600","ADVAIR ","AER 250\/50","60","Select","Select",""],["","16571020210","DICLOFENAC ","TAB 50MG DR","30","Select","Select",""],["","93742698","MONTELUKAST ","TAB 10MG","90","Select","Select",""],["","50111064801","FLUOXETINE ","CAP 20MG","30","Select","Select",""],["","59762453701","MEDROXYPR ","INJ 150MG\/ML","1","Select","Select",""],["","70710122600","AMITRIPTYLIN ","TAB 25MG","30","Select","Select",""],["","54327099","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","378827052","ALBUTEROL ","NEB 0.00083","375","Select","Select",""],["","59746000103","METHYLPRED ","TAB 4MG","21","Select","Select",""],["","68180016006","AZITHROMYCIN ","TAB 250MG","3","Select","Select",""],["","378064205","PREDNISONE ","TAB 20MG","10","Select","Select",""],["","47781030801","NITROFUR ","CAP 100MG","8","Select","Select",""],["","45802046564","KETOCONAZOLE ","SHA 0.02","120","Select","Select",""],["","69097094312","GABAPENTIN ","CAP 300MG","270","Select","Select",""],["","67877032105","IBUPROFEN ","TAB 800MG","90","Select","Select",""],["","70710113908","FLUCONAZOLE ","TAB 150MG","1","Select","Select",""],["","65162019050","NAPROXEN ","TAB 500MG","30","Select","Select",""],["","65862050320","AMOX\/K ","TAB 875-125","10","Select","Select",""],["","406012305","HYDROCO\/APAP ","TAB 5-325MG","20","Select","Select",""],["","43547040510","METHOCARBAM ","TAB 500MG","56","Select","Select",""],["","42858010201","OXYCOD\/APAP ","TAB 5-325MG","12","Select","Select",""],["","93206406","CILOSTAZOL ","TAB 100MG","60","Select","Select",""],["","14539067401","HYDROXYZ ","25MG","60","Select","Select",""],["","93310905","AMOXICILLIN ","500MG","15","Select","Select",""],["","59310057922","PROAIR","","17","Select","Select",""],["","00173069600","ADVAIR","250\/50","60","Select","Select",""],["","59762453701","MEDROXYPR","150MG\/ML","1","Select","Select",""],["","14539067401","HYDROXYZ","25MG","60","Select","Select",""],["","47781030801","NITROFUR","100MG","8","Select","Select",""],["","65862050320","AMOX\/K","875-125","10","Select","Select",""],["","65862085901","FAMOTIDINE","20MG","60","Select","Select",""],["","53489011905","DOXYCYCL ","CAP 100MG","20","Select","Select",""],["","65862085901","FAMOTIDINE ","TAB 20MG","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","",""],["Yes","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":""}]}]}