{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JANIE M TAYLOR","gend":1,"add":"1807 CLEARY RD ","city":"RICHMOND ","state":"VA","zip":"23223-9998","dob":"1949-12-10","age":"","mstatus":"","insh":11014015,"cliId":"8D25MY8KE64","pno":8045733230,"cno":8042777718,"email":"","ename":"","eno":"","pphy":"BRADLEY, MICHAEL  ","ppno":8048287999,"pcpadd":"7101 Jahnke Rd","pcpcity":"Richmond ","pcpstate":"VA","pcpzip":232254017,"pcpcounty":"","pcpid":"P0112787","pcpname":"MCV NORTH HOSPITAL","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1807 CLEARY RD ","madd2":"","madd3":"","mcity":"RICHMOND ","mstate":"VA","mzip":"23223-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R69","I51.7","R00.1","R07.9","F14.10","R91.8","N76.0","M19.90","N89.8","I49.1","J98.11","R30.0","I61.5","I61.8","J69.0","J96.01","J15.211","J96.02","G81.94","J95.851","J44.9","I61.0","I10","E87.6","F10.10","Y84.8","Z23","Z72.0","Z79.899","F14.90","I61.9","Z46.82","R41.0","R53.1","R41.82","T50.901A","F19.10","F10.129","R55","I62.9","R11.10","R42","R40.2140","R40.2240","R40.2340","F17.210","Z79.51","Z79.1","J91.8","Z46.59","Z99.11","J98.19","J98.4","J90","T85.528A","Z98.2","J81.1","R50.9","K56.7","I69.154","J96.90","B95.61","G91.9","I62.00","R45.1","R94.31","R09.89","I60.9","T88.4XXA","R26.2","J98.6","R93.3","R41.89","E87.1","I69.292","J96.91","G93.41","J44.0","G72.81","I69.222","I69.219","I69.291","R13.10","F17.200","M25.569","R27.9","I72.0","F19.20","F41.9","I69.118","I69.191","R51","F41.8","M25.559","M25.561","M25.551","M79.651","R10.2","M16.0","M17.10","Z13.0","M17.11","M16.11","M47.816","M47.818","R29.6","M54.5","M25.511","F14.11","M25.552","I69.111","I69.110","I69.151","F10.99","Z87.891","S76.311A","M70.61","R41.841","Z73.6","R26.89","M62.81","R41.9","M51.36","M47.817","M85.88","M41.9","M51.37","M19.011","M75.01","F19.11","M79.604","R27.8","M25.512","M19.042","I69.198","M19.041","Z91.81","I61.6","Z74.1","I69.115","R51.9","F32.9","K21.9","R06.02","R07.89","L29.9","Z00.00"],"date":["2021-11-18","2021-05-05","2021-05-05","2021-05-29","2021-05-06","2021-05-05","2021-05-20","2021-05-20","2021-05-20","2021-05-29","2021-05-29","2020-06-17","2020-07-05","2020-07-09","2020-07-02","2020-06-29","2020-06-20","2020-06-28","2020-06-23","2020-07-28","2021-08-12","2020-08-13","2020-11-18","2020-06-20","2020-11-06","2020-07-10","2020-06-20","2020-06-20","2020-06-20","2020-07-09","2020-07-01","2020-07-01","2020-06-20","2020-06-20","2020-07-10","2020-06-20","2020-06-20","2020-06-20","2020-06-20","2020-07-28","2020-06-20","2020-06-20","2020-06-20","2020-06-20","2020-06-20","2020-06-20","2020-06-20","2020-11-06","2020-06-20","2020-06-23","2020-06-29","2020-06-26","2020-07-01","2020-07-01","2020-06-22","2020-07-03","2020-06-23","2020-06-28","2020-06-23","2020-06-29","2020-06-29","2020-06-29","2020-06-27","2020-06-27","2020-06-29","2020-07-04","2020-06-30","2020-06-30","2020-07-01","2020-10-02","2020-07-01","2020-07-02","2020-07-28","2020-07-28","2020-07-10","2020-09-01","2020-09-01","2020-07-10","2020-07-10","2020-07-10","2020-07-10","2020-07-10","2020-07-10","2020-07-10","2020-07-10","2020-10-02","2020-08-20","2020-07-31","2020-11-18","2020-09-01","2020-09-01","2020-09-16","2020-11-30","2020-08-20","2021-10-13","2020-10-07","2020-08-21","2020-08-21","2020-09-14","2020-09-03","2020-09-03","2021-10-13","2020-10-15","2020-09-14","2020-10-15","2020-09-14","2020-09-14","2021-10-13","2020-11-18","2020-09-21","2020-09-16","2020-09-16","2020-11-18","2020-11-18","2020-11-18","2020-09-21","2020-09-21","2020-11-06","2020-11-06","2020-10-02","2020-11-06","2020-11-06","2020-10-15","2020-10-15","2020-10-15","2020-10-15","2020-10-15","2021-10-13","2020-10-15","2020-10-15","2020-10-15","2020-11-06","2020-11-06","2020-11-06","2020-11-06","2020-11-06","2020-11-06","2020-11-06","2020-11-06","2020-11-18","2020-11-18","2020-11-18","2020-12-08","2021-05-05","2021-05-29","2021-08-12","2021-09-13"],"priorHcc":[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":[]},{"a":[]}]},{"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":[["","21922000909","DICLOFENAC","GEL 0.01","","Select","Select",""],["","29300012501","MELOXICAM","TAB 15MG","","Select","Select",""],["","69543013611","TRAMADOL HCL","TAB 50MG","","Select","Select",""],["","185012201","NITROFURANTN","CAP 100MG","","Select","Select",""],["","173086910","ANORO ELLIPT","AER 62.5-25","","Select","Select",""],["","93317431","ALBUTEROL SUL","FAT E","","Select","Select",""],["","67877024201","QUETIAPINE","TAB 25MG","","Select","Select",""],["","43547034703","PAROXETINE","TAB 10MG","","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","16729017201","AMITRIPTYLIN","TAB 25MG","","Select","Select",""],["","27241009706","DULOXETINE","CAP 20MG","","Select","Select",""],["","29300012501","MELOXICAM ","TAB 15MG","30","Select","Select",""],["","21922000909","DICLOFENAC ","GEL 0.01","400","Select","Select",""],["","67877024201","QUETIAPINE ","TAB 25MG","30","Select","Select",""],["","69543013611","TRAMADOL ","TAB 50MG","28","Select","Select",""],["","185012201","NITROFURANTN ","CAP 100MG","20","Select","Select",""],["","55111015810","OMEPRAZOLE ","CAP 20MG","30","Select","Select",""],["","27241009706","DULOXETINE ","CAP 20MG","30","Select","Select",""],["","93317431","ALBUTEROL ","FAT E","8.5","Select","Select",""],["","173086910","ANORO ","AER 62.5-25","60","Select","Select",""],["","43547034703","PAROXETINE ","TAB 10MG","30","Select","Select",""],["","16729017201","AMITRIPTYLIN ","TAB 25MG","30","Select","Select",""],["","23155065201","METRONIDAZOL ","500MG","14","Select","Select",""],["","67405060301","FLUCONAZOLE ","150MG","1","Select","Select",""],["","00173086910","ANORO","62.5-25","60","Select","Select",""],["","00093317431","ALBUTEROL","E","8.5","Select","Select",""],["","69543013611","TRAMADOL","50MG","30","Select","Select",""],["","67405060301","FLUCONAZOLE","150MG","1","Select","Select",""],["","23155065201","METRONIDAZOL","500MG","14","Select","Select",""],["","50228043605","NAPROXEN","500MG","60","Select","Select",""],["","50228043605","NAPROXEN ","TAB 500MG","60","Select","Select",""],["","51672130009","AMMONIUM ","LOT 0.12","400","Select","Select",""],["","00168009930","KETOCONAZOLE ","CRE 0.02","90","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","",""],["Yes","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":""}]}]}