{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"YI Q HE","gend":0,"add":"12340 Hepler Ridge Ct","city":"Glen Allen  ","state":"VA","zip":"23059-7181","dob":"1943-06-29","age":"","mstatus":"","insh":11007778,"cliId":"6HW5GQ8EN95","pno":8043069000,"cno":8043069000,"email":"","ename":"","eno":"","pphy":"ASHOK PATEL MD ","ppno":8043534703,"pcpadd":"2015 Monument Ave Frnt","pcpcity":"Richmond ","pcpstate":"VA","pcpzip":232202739,"pcpcounty":"","pcpid":"P0124154","pcpname":"LEXINGTON COURT REHABILITATION & HEALTHCARE CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"12340 Hepler Ridge Ct","madd2":"","madd3":"","mcity":"Glen Allen  ","mstate":"VA","mzip":"23059-7181","pcpfaxno":"                    ","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["ASIAN\/PACIFIC"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["Z71.2","M54.9","Z90.89","C22.0","B18.1","K21.9","Z85.05","Z95.0","Z20.828","Z03.818","I49.5","Z45.010","N20.0","R91.8","Z86.19","K74.60","Z86.79","R93.429","I10","Z01.818","I83.90","K31.7","K29.70","I85.00","K31.89","K76.6","K44.9","K22.8","I86.4","I48.0","N40.1","R35.0","I48.91","Z08","M79.18","R59.0","R91.1","I27.20","J98.11","I51.7","Z87.448","Z45.018","R21","L29.9","R60.0","M79.89","R22.41","L28.2","E78.5","M25.561","Z78.9","M25.569","M17.11","M25.461","R93.2","N28.1","Z11.59","R93.49","Z04.9","W57.XXXA","I48.92","Z45.09","L30.9","L85.3","L02.224","Z20.822","E78.2","R73.01","B18.2","Z23","Z13.220","Z51.81","S92.422A","S90.812A","S92.422D"],"date":["2019-11-26","2019-11-26","2019-11-26","2021-11-23","2021-05-25","2021-09-29","2020-11-24","2021-07-02","2021-03-21","2021-03-21","2021-10-13","2021-10-13","2021-11-15","2020-05-14","2020-05-26","2021-09-29","2021-05-25","2020-05-26","2021-09-29","2020-06-24","2020-06-26","2020-06-26","2020-06-26","2020-06-26","2020-06-26","2020-06-26","2020-11-13","2020-06-26","2020-06-26","2021-01-06","2019-07-22","2019-07-22","2021-10-13","2019-08-13","2019-08-13","2019-11-14","2019-11-14","2019-11-14","2019-11-14","2019-11-14","2020-11-24","2021-10-13","2021-04-28","2021-04-08","2021-07-02","2021-04-09","2021-04-09","2021-04-09","2021-04-28","2021-04-28","2021-04-28","2021-05-13","2021-05-13","2021-05-13","2021-11-15","2021-11-15","2021-05-25","2021-05-25","2021-05-25","2021-07-02","2021-07-13","2021-07-13","2021-09-22","2021-09-22","2021-09-22","2021-03-21","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-09-29","2021-11-07","2021-11-07","2021-11-18"],"priorHcc":["","","",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":[["","68180072003","AMLODIPINE","TAB 5MG","","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","378064110","PREDNISONE","TAB 10MG","","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","","Select","Select",""],["","70461002003","FLUAD","INJ 2020-21","","Select","Select",""],["","42806016005","HYDROXYZ ","TAB 25MG","40","Select","Select",""],["","68180072003","AMLODIPINE ","TAB 5MG","90","Select","Select",""],["","62175061743","PANTOPRAZOLE ","TAB 40MG","90","Select","Select",""],["","378064110","PREDNISONE ","TAB 10MG","12","Select","Select",""],["","67877025130","TRIAMCINOLON ","CRE 0.001","30","Select","Select",""],["","70461002003","FLUAD ","INJ 2020-21","0.5","Select","Select",""],["","31722070190","LOSARTAN ","50MG","90","Select","Select",""],["","42806016005","HYDROXYZ","25MG","40","Select","Select",""],["","31722070190","LOSARTAN","50MG","90","Select","Select",""],["","43386009662","CLOBETASOL","0.05%","60","Select","Select",""],["","00093101042","MUPIROCIN","2%","22","Select","Select",""],["","68180012101","CEPHALEXIN ","CAP 250MG","40","Select","Select",""],["","00093101042","MUPIROCIN ","OIN 0.02","22","Select","Select",""],["","43386009662","CLOBETASOL ","OIN 0.0005","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","",""],["No","Select","","","","","Select","",""],["No","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":""}]}]}