{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARIE K HARRINGTON","gend":1,"add":"15255   IRA HOFFMAN LANE","city":"CULPEPER","state":"VA","zip":227019999,"dob":"1950-11-01","age":"","mstatus":"","insh":11015097,"cliId":"6HN7KY3GM57","pno":8046292379,"cno":"","email":"","ename":"","eno":"","pphy":"BABAR, AHMAD","ppno":7037069897,"pcpadd":"4376 Germanna Hwy","pcpcity":"Locust Grove","pcpstate":"VA","pcpzip":225082008,"pcpcounty":"","pcpid":"P0111019","pcpname":"UVA PRIMARY CARE COMMONWEALTH MEDICAL","plan":"VPHP - VIRGINIA PREMIER","program":"Medicare","lob":"DSNP","region":"NORTHERN\/WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["C80.1","H90.A21","R42","I67.82","H91.91","R68.89","C90.00","I87.303","E11.42","R60.0","B35.1","G47.33","N18.3","N25.81","D61.89","I10","R39.81","D63.1","N18.9","M25.562","N32.81","N39.41","R35.1","R35.0","E11.59","R60.1","E11.9","Z51.11","Z71.2","D64.9","Z79.899","I65.22","I65.03","I70.8","I67.9","R55","Z23","I13.0","I50.42","E11.22","N18.30","Z79.84","J44.9","F33.9","Z99.81","Z79.4","E11.40","G45.0","E78.5","Z91.81","Z79.02","Z79.891","Z85.6","Z88.5","Z88.6","Z79.3","Z87.09","Z79.51","H81.4","E66.9","R01.0","I65.01","I35.0","I51.9","N18.31","I65.02","S60.219A","M25.432","I11.0","I50.31","R53.83","R06.09","R26.89","M13.80","R01.1","Z79.01","Z85.828","F32.9","R06.00","N31.9","I89.0","I25.10","R07.89","M54.5","I50.32","J98.11","E66.01","Z68.41","E04.9","R07.9","G89.29","R06.02","R69","I50.33","I27.20","R60.9","M25.50","I12.9","G47.30","R52","E11.3293","H04.123","H25.13","G43.109","M19.072","E87.0","N17.9","N18.32","H90.3","R06.83","R06.81","R53.82","G47.00","H25.011","H25.11","K57.30","Z85.72","R11.2","R19.7","Z85.79","R07.2","H81.10","F41.8","R11.10","Z01.818","G47.36","I49.9","R53.1","R11.12","R90.82","L84","E11.29","E55.9","G62.9","H25.12","R26.9","R32","Z20.822","M79.89","N28.9","G90.9","G40.A09","M62.81","R26.2","R26.81","F29","E08.43","G40.89","F41.9","J18.9","N39.0","Z92.29","I73.9","M20.11","M20.12","E03.9","K59.00","F33.0","D63.0","G43.909","I25.9","R00.2","Z86.79","I95.2","I67.4","R41.82","C90.01"],"date":["2020-10-07","2020-08-09","2021-06-23","2021-06-23","2020-08-09","2021-06-02","2021-06-28","2021-01-20","2021-03-30","2021-05-13","2021-05-06","2021-06-16","2020-09-21","2020-08-20","2021-01-28","2021-06-29","2021-06-29","2021-06-01","2021-04-21","2020-08-24","2021-04-29","2021-04-29","2020-09-08","2020-09-08","2021-03-30","2021-01-20","2021-06-23","2021-01-25","2020-09-21","2021-05-19","2021-06-23","2020-10-21","2020-09-22","2020-10-21","2020-09-22","2021-06-25","2020-09-29","2021-06-28","2021-04-29","2021-04-29","2021-06-21","2021-06-23","2021-05-01","2021-05-01","2021-04-29","2020-10-05","2021-06-23","2021-06-23","2021-06-23","2020-10-10","2021-02-16","2020-10-10","2020-12-04","2021-06-23","2021-06-23","2020-10-10","2020-10-10","2021-06-23","2021-04-29","2021-06-23","2021-06-23","2020-10-14","2021-06-25","2021-04-02","2021-06-01","2020-10-21","2020-10-23","2020-10-23","2021-01-05","2020-10-28","2021-01-05","2021-06-23","2021-02-02","2021-01-05","2021-01-05","2020-10-28","2020-10-28","2021-05-12","2020-11-06","2020-11-09","2020-11-18","2020-12-04","2021-06-25","2020-12-06","2020-12-07","2021-04-16","2021-06-23","2020-12-04","2020-12-04","2020-12-21","2020-12-06","2021-03-12","2021-04-01","2021-01-05","2021-01-05","2021-01-05","2021-01-05","2021-04-16","2021-01-12","2021-01-12","2021-01-15","2021-01-15","2021-01-15","2021-01-15","2021-01-20","2021-02-26","2021-05-01","2021-02-26","2021-02-02","2021-03-04","2021-02-03","2021-02-03","2021-02-03","2021-02-09","2021-02-23","2021-02-16","2021-02-16","2021-02-16","2021-02-16","2021-02-16","2020-12-04","2020-12-05","2020-12-21","2021-02-16","2021-02-26","2021-03-04","2021-03-04","2021-03-12","2021-03-12","2021-03-12","2021-05-06","2021-06-23","2021-04-12","2021-04-12","2021-04-13","2021-05-17","2021-04-16","2021-04-16","2021-04-16","2021-04-16","2021-04-21","2021-05-21","2021-05-13","2021-05-01","2021-05-01","2021-05-01","2021-05-01","2021-05-01","2021-05-01","2021-05-01","2021-04-25","2021-04-29","2021-05-06","2021-05-06","2021-05-06","2021-05-15","2020-09-16","2020-09-16","2020-09-16","2020-09-16","2020-09-16","2021-05-12","2021-05-12","2021-06-23","2021-06-23","2021-06-23","2021-06-23"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"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":[["","591024010","LORAZEPAM","TAB 0.5MG","","Select","Select",""],["","65162062710","TRAMADOL HCL","TAB 50MG","","Select","Select",""],["","69452029020","ACYCLOVIR","TAB 400MG","","Select","Select",""],["","62175027141","OXYBUTYNIN","TAB 10MG ER","","Select","Select",""],["","93720298","PRAVASTATIN","TAB 40MG","","Select","Select",""],["","68382013814","TOPIRAMATE","TAB 25MG","","Select","Select",""],["","68180052002","LISINOP\/HCTZ","TAB 20-25MG","","Select","Select",""],["","31722082030","ARIPIPRAZOLE","TAB 5MG","","Select","Select",""],["","67877019810","AMLODIPINE","TAB 5MG","","Select","Select",""],["","469260130","MYRBETRIQ","TAB 25MG","","Select","Select",""],["","69499034430","AZESCO","TAB 13-1MG","","Select","Select",""],["","62175012837","ISOSORB MONO","TAB 30MG ER","","Select","Select",""],["","69097040707","METOPROL SUC","TAB 50MG ER","","Select","Select",""],["","65862012701","TORSEMIDE","TAB 20MG","","Select","Select",""],["","591040810","LISINOPRIL","TAB 20MG","","Select","Select",""],["","65862035705","CLOPIDOGREL","TAB 75MG","","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","","Select","Select",""],["","65162010150","GABAPENTIN","CAP 100MG","","Select","Select",""],["","17478071310","OFLOXACIN","DRO 0.3% OP","","Select","Select",""],["","65175014","ILEVRO","DRO 0.3% OP","","Select","Select",""],["","65924007","DUREZOL","EMU 0.0005","","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","","Select","Select",""],["","68001024617","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","67877056105","METFORMIN","TAB 500MG","","Select","Select",""],["","69315011710","FUROSEMIDE","TAB 40MG","","Select","Select",""],["","93317431","ALBUTEROL SUL","FAT E","","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","","Select","Select",""],["","61314012605","KETOROLAC","SOL 0.005","","Select","Select",""],["","69452029020","ACYCLOVIR ","TAB 400MG","60","Select","Select",""],["","591024010","LORAZEPAM ","TAB 0.5MG","15","Select","Select",""],["","469260130","MYRBETRIQ ","TAB 25MG","30","Select","Select",""],["","65162062710","TRAMADOL ","TAB 50MG","10","Select","Select",""],["","69499034430","AZESCO ","TAB 13-1MG","90","Select","Select",""],["","62175027141","OXYBUTYNIN ","TAB 10MG ER","30","Select","Select",""],["","93720298","PRAVASTATIN ","TAB 40MG","30","Select","Select",""],["","65862035705","CLOPIDOGREL ","TAB 75MG","30","Select","Select",""],["","31722082030","ARIPIPRAZOLE ","TAB 5MG","30","Select","Select",""],["","67877019810","AMLODIPINE ","TAB 5MG","30","Select","Select",""],["","43547035411","LISINOPRIL ","TAB 20MG","30","Select","Select",""],["","68382013814","TOPIRAMATE ","TAB 25MG","30","Select","Select",""],["","69097040707","METOPROL ","TAB 50MG ER","30","Select","Select",""],["","68180052002","LISINOP\/HCTZ ","TAB 20-25MG","160","Select","Select",""],["","59746012106","MECLIZINE ","TAB 25MG","30","Select","Select",""],["","65862012701","TORSEMIDE ","TAB 20MG","30","Select","Select",""],["","62175012837","ISOSORB ","TAB 30MG ER","30","Select","Select",""],["","65162010150","GABAPENTIN ","CAP 100MG","30","Select","Select",""],["","67877056105","METFORMIN ","TAB 500MG","360","Select","Select",""],["","58160082311","SHINGRIX ","INJ 50\/0.5ML","1","Select","Select",""],["","68180096301","ALBUTEROL ","AER HFA","8.5","Select","Select",""],["","65924007","DUREZOL ","EMU 0.0005","5","Select","Select",""],["","65175014","ILEVRO ","DRO 0.3% OP","3","Select","Select",""],["","17478071310","OFLOXACIN ","DRO 0.3% OP","5","Select","Select",""],["","61314012605","KETOROLAC ","SOL 0.005","5","Select","Select",""],["","68001024617","ONDANSETRON ","TAB 4MG ODT","28","Select","Select",""],["","69315011710","FUROSEMIDE ","TAB 40MG","60","Select","Select",""],["","68001023703","CLONIDINE ","0.1MG","30","Select","Select",""],["","68001040303","LEVETIRACETA ","500MG","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":[[["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["No","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":""}]}]}