{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATRICIA G HALL","gend":1,"add":"24 BALDWIN ST  ","city":"DANVILLE ","state":"VA","zip":"24541-9998","dob":"1950-09-20","age":"","mstatus":"","insh":11012491,"cliId":"5X98MW6DU63","pno":4344298897,"cno":4344298897,"email":"","ename":"","eno":"","pphy":"LAHURD JR, NEIL J ","ppno":4344461070,"pcpadd":"949 PINEY FOREST RD","pcpcity":"DANVILLE ","pcpstate":"VA","pcpzip":245401591,"pcpcounty":"","pcpid":"P9058674","pcpname":"GODOCS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"24 BALDWIN ST  ","madd2":"","madd3":"","mcity":"DANVILLE ","mstate":"VA","mzip":"24541-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["Z51.81","E78.2","I10","F41.9","K21.9","E11.65","F51.01","Z12.31","I87.2","I13.0","E11.22","N18.9","I50.9","J45.909","Z79.4","Z79.899","E78.5","R06.00","E66.9","E11.9","Z98.890","D64.9","H40.023","H25.813","H43.811","E55.9","N18.3","E11.29","I13.10","R80.9","E66.01","B34.9","Z20.828","G89.29","H90.3","H93.293","H61.22","N39.0","Z23","N18.30","R30.0","R07.9","R42","R06.2","I25.10","I70.213","Z12.11","L81.9","Z13.29","F32.9","R19.5","H25.13","H04.123","H52.03","H52.223","H52.4","D12.6","K29.60","D12.3","D12.5","Z86.010","Z80.0","K29.00","K27.3"],"date":["2020-03-13","2021-06-10","2021-11-10","2021-06-10","2021-11-05","2021-09-20","2020-08-06","2020-05-27","2021-04-15","2020-05-29","2020-05-29","2021-10-20","2021-05-24","2021-10-20","2020-06-05","2020-06-05","2021-10-20","2021-09-29","2021-09-29","2021-11-12","2020-06-10","2021-09-29","2021-11-12","2020-07-15","2020-07-15","2020-08-06","2020-09-03","2021-03-01","2021-08-30","2021-03-01","2020-09-03","2020-09-11","2020-09-11","2021-09-20","2021-01-25","2021-01-25","2021-01-25","2021-10-20","2021-09-20","2021-03-01","2021-03-31","2021-09-27","2021-04-20","2021-04-20","2021-09-29","2021-05-24","2021-11-05","2021-06-10","2021-09-20","2021-11-01","2021-11-05","2021-11-12","2021-11-12","2021-11-12","2021-11-12","2021-11-12","2021-11-05","2021-11-05","2021-11-05","2021-11-05","2021-11-05","2021-11-05","2021-11-05","2021-11-05"],"priorHcc":["","",null,"",null,"","","","","","","","","","","","","","",null,"","",null,"","","","","","","","","","","","","","","","","","","","","","","",null,"","",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":[["","193731221","CONTOUR","TES NEXT","","Select","Select",""],["","31722072690","MONTELUKAST","TAB 10MG","","Select","Select",""],["","16729013401","ALLOPURINOL","TAB 100MG","","Select","Select",""],["","169406012","VICTOZA","INJ 18MG\/3ML","","Select","Select",""],["","65862037301","ESCITALOPRAM","TAB 5MG","","Select","Select",""],["","169255013","TRESIBA FLEX","INJ 200UNIT","","Select","Select",""],["","45963070911","METOPROL SUC","TAB 25MG ER","","Select","Select",""],["","143992801","CIPROFLOXACN","TAB 500MG","","Select","Select",""],["","69097082112","GEMFIBROZIL","TAB 600MG","","Select","Select",""],["","50111043302","TRAZODONE","TAB 50MG","","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","","Select","Select",""],["","76204060060","IPRATROPIUM\/","SOL ALBUTER","","Select","Select",""],["","169185550","NOVOFINE PLS","MIS 32GX4MM","","Select","Select",""],["","62175011843","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","45963067611","METOPROLOL","TAB 50MG ER","","Select","Select",""],["","169185189","NOVOFINE","MIS 32GX6MM","","Select","Select",""],["","70954000520","OXYBUTYNIN","TAB 5MG","","Select","Select",""],["","406051205","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","68462043730","OLMESA MEDOX","TAB 20MG","","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","","Select","Select",""],["","65162010150","GABAPENTIN","CAP 100MG","","Select","Select",""],["","193658621","MICROLET","MIS LANCETS","","Select","Select",""],["","65862053820","LEVOFLOXACIN","TAB 750MG","","Select","Select",""],["","193731221","CONTOUR ","TES NEXT","300","Select","Select",""],["","65862037301","ESCITALOPRAM ","TAB 5MG","30","Select","Select",""],["","69097052444","DICLOFENAC ","GEL 0.01","100","Select","Select",""],["","16729013401","ALLOPURINOL ","TAB 100MG","90","Select","Select",""],["","31722072690","MONTELUKAST ","TAB 10MG","90","Select","Select",""],["","169255013","TRESIBA ","INJ 200UNIT","3","Select","Select",""],["","169406013","VICTOZA ","INJ 18MG\/3ML","3","Select","Select",""],["","45963067611","METOPROLOL ","TAB 50MG ER","90","Select","Select",""],["","45963070911","METOPROL ","TAB 25MG ER","30","Select","Select",""],["","69097082112","GEMFIBROZIL ","TAB 600MG","180","Select","Select",""],["","169185550","NOVOFINE ","MIS 32GX4MM","100","Select","Select",""],["","50111043302","TRAZODONE ","TAB 50MG","30","Select","Select",""],["","65862053820","LEVOFLOXACIN ","TAB 750MG","7","Select","Select",""],["","143992801","CIPROFLOXACN ","TAB 500MG","14","Select","Select",""],["","62175011843","OMEPRAZOLE ","CAP 20MG","90","Select","Select",""],["","76204060060","IPRATROPIUM\/ ","SOL ALBUTER","1,080.00","Select","Select",""],["","70954000520","OXYBUTYNIN ","TAB 5MG","90","Select","Select",""],["","406051205","OXYCOD\/APAP ","TAB 5-325MG","90","Select","Select",""],["","68462043730","OLMESA ","TAB 20MG","180","Select","Select",""],["","193658621","MICROLET ","MIS LANCETS","300","Select","Select",""],["","68180072103","AMLODIPINE ","TAB 10MG","90","Select","Select",""],["","65162010150","GABAPENTIN ","CAP 100MG","90","Select","Select",""],["","65862001105","SERTRALINE ","25MG","30","Select","Select",""],["","713063415","MOMETASONE ","0.10%","15","Select","Select",""],["","00169255013","TRESIBA","200UNIT","15","Select","Select",""],["","65862001105","SERTRALINE","25MG","30","Select","Select",""],["","45963070911","METOPROL","25MG ER","30","Select","Select",""],["","68462043730","OLMESA","20MG","180","Select","Select",""],["","00713063415","MOMETASONE","0.001","15","Select","Select",""],["","65162062711","TRAMADOL","50MG","90","Select","Select",""],["","65162062711","TRAMADOL ","TAB 50MG","90","Select","Select",""],["","59762040101","SUCRALFATE ","TAB 1GM","360","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":""}]}]}