{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARY R BUSTER","gend":1,"add":"520 CARRINGTON ST ","city":"SOUTH BOSTON","state":"VA","zip":"24592-9998","dob":"1920-04-15","age":"","mstatus":"","insh":11015054,"cliId":"5KM0XW8MJ25","pno":4345726143,"cno":4345726143,"email":"","ename":"","eno":"","pphy":"ARTHUR, MELISSA P P  ","ppno":"               ","pcpadd":"2232 WILBORN AVENUE","pcpcity":"SOUTH BOSTON","pcpstate":"VA","pcpzip":245921662,"pcpcounty":"","pcpid":"P0060083","pcpname":"HALIFAX PRIMARY CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"520 CARRINGTON ST ","madd2":"","madd3":"","mcity":"SOUTH BOSTON","mstate":"VA","mzip":"24592-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["Z23","I10","K21.9","S72.452A","Z74.01","R52","Z99.89","I45.19","I44.4","S72.401A","S89.92XA","W19.XXXA","S72.492A","T14.90XA","Z09","S72.402S","R39.81","S72.492D","W18.39XD","R91.8","S72.465A","M85.89","M25.562","M25.462","Y93.01","Z20.822","W18.39XA","S79.192A","I42.9","Z74.1","Z91.81","Z79.01","R60.9","M24.662","I95.9","R09.02","M79.605","R26.89","Z74.09","R53.1","S72.352A","Z74.3","S82.142D","M89.8X9"],"date":["2020-10-08","2021-05-17","2021-06-09","2021-02-27","2021-02-26","2021-02-26","2021-02-26","2021-02-27","2021-02-27","2021-02-27","2021-02-27","2021-02-28","2021-02-27","2021-02-27","2021-03-10","2021-07-14","2021-10-29","2021-10-26","2021-10-08","2021-02-26","2021-02-26","2021-02-26","2021-06-04","2021-02-26","2021-02-26","2021-02-26","2021-02-26","2021-02-26","2021-06-16","2021-04-19","2021-06-09","2021-04-19","2021-05-17","2021-06-14","2021-06-16","2021-06-16","2021-10-26","2021-10-26","2021-07-14","2021-07-14","2021-02-28","2021-06-16","2021-10-08","2021-08-06"],"priorHcc":["","","","","","","","","","","","","","","","","",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":[["","67877022205","GABAPENTIN","CAP 100MG","","Select","Select",""],["","378001805","METOPROL TAR","TAB 25MG","","Select","Select",""],["","61314054701","LATANOPROST","SOL 0.00005","","Select","Select",""],["","3089321","ELIQUIS","TAB 2.5MG","","Select","Select",""],["","65162062750","TRAMADOL HCL","TAB 50MG","","Select","Select",""],["","65162062750","TRAMADOL ","TAB 50MG","6","Select","Select",""],["","3089321","ELIQUIS ","TAB 2.5MG","60","Select","Select",""],["","67877022205","GABAPENTIN ","CAP 100MG","90","Select","Select",""],["","378001805","METOPROL ","TAB 25MG","30","Select","Select",""],["","61314054701","LATANOPROST ","SOL 0.00005","2.5","Select","Select",""],["","57237007710","ONDANSETRON ","4MG ODT","20","Select","Select",""],["","43386043201","OXYCODONE ","5MG","30","Select","Select",""],["","55111015810","OMEPRAZOLE ","20MG","90","Select","Select",""],["","00378001805","METOPROL","25MG","30","Select","Select",""],["","65162062750","TRAMADOL","50MG","6","Select","Select",""],["","43386043201","OXYCODONE","5MG","30","Select","Select",""],["","55111015810","OMEPRAZOLE","20MG","90","Select","Select",""],["","57237007710","ONDANSETRON","4MG ODT","20","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":""}]}]}