{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BILLY   L DYER","gend":0,"add":"1055 LEIGH MCKAY TRL","city":"SOUTH BOSTON","state":"VA","zip":"24592-9998","dob":"1942-11-29","age":"","mstatus":"","insh":"900038427*01","cliId":"","pno":"434\/470-0700","cno":"","email":"","ename":"","eno":"","pphy":"PATEL, BABITA B MD","ppno":"434\/517-5180","pcpadd":"1129 N MAIN ST","pcpcity":"SOUTH BOSTON","pcpstate":"VA","pcpzip":24592,"pcpcounty":"","pcpid":"","pcpname":"HALIFAX INTERNAL MEDICINE PLLC","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/517-6179","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N17.9","D69.6","M25.572","N39.0","R31.9","R42.","M79.605","I10.","N40.0","Z86.73","Z95.3","Z86.010","Z87.891","Z95.1","Z95.0","Z80.52","Z80.8","Z80.0","R07.9","S99.912A","R60.0","S89.92XA","M85.862","M79.672","A41.50","G93.41","D69.3","E87.2","G47.33","B02.9","I25.10","I48.0","I49.5","S82.832D","E66.9","Z79.899","Z88.8","A41.9","D72.829","I50.9","R26.89","Z74.09","D50.9","H40.9","I87.2","K57.90","E78.2","Z91.81","R05.","N32.81","I63.9","R26.81","Z45.018","I08.2","I35.0","R06.00","Z74.01","R53.1","M79.604","I48.19","Z20.828","Z51.11","D59.1","Z53.09","R27.9","R41.0","B96.89","R50.9","M62.81","R35.0","S82.832A","Z95.2","R29.6","R82.998","R30.0","S40.022A","D64.9","E53.8","M10.9","E78.00","E55.9","F41.1","I25.810","I27.20","E78.5","K21.9","K92.1","E86.0","R39.15","N39.41","R35.1","Z11.59","R23.3","R53.83","R41.82","Z23.","L97.919","D84.9","K06.8","Z66.","N40.1","N28.9","Z45.010","R90.89","S20.219A","I11.0","I08.3","I83.013","L97.319","R06.02","S93.402A","G47.30","G62.9","R06.09","I08.1","F41.9","I48.91","Z01.84","I73.9","R59.0","R93.421","K80.20","D59.10","B02.8","L03.818","R32.","Z74.1","I51.7","L89.309"],"date":["2020-07-31","2021-12-17","2020-09-16","2020-11-04","2020-09-03","2020-09-03","2020-09-03","2021-08-05","2021-02-06","2020-10-08","2021-11-02","2020-09-03","2021-02-06","2021-09-28","2021-11-02","2020-09-03","2020-09-03","2020-09-03","2020-09-19","2020-09-03","2020-09-03","2020-09-03","2020-09-03","2020-09-10","2020-09-19","2020-09-19","2021-09-16","2020-09-19","2021-04-23","2020-10-08","2021-09-28","2021-09-28","2021-05-25","2020-10-20","2020-09-19","2020-09-19","2020-09-19","2020-09-19","2020-09-19","2021-09-28","2021-09-17","2021-08-20","2021-02-06","2021-02-06","2021-02-06","2021-02-06","2021-07-23","2021-09-17","2021-08-06","2021-04-02","2021-04-02","2021-04-02","2021-05-25","2020-06-04","2020-06-04","2021-07-23","2020-07-23","2020-07-23","2020-08-27","2020-09-05","2021-08-06","2020-09-10","2020-09-10","2020-09-10","2020-09-10","2020-09-19","2020-09-19","2020-09-19","2021-08-12","2020-11-02","2020-10-28","2021-11-02","2021-08-12","2021-08-12","2021-09-17","2021-12-14","2020-07-23","2020-01-17","2020-10-20","2020-10-20","2020-10-20","2020-01-17","2020-06-29","2021-11-02","2020-07-25","2020-07-25","2020-07-24","2020-07-24","2020-11-02","2020-11-02","2020-11-02","2020-06-26","2020-07-22","2020-07-31","2020-09-19","2021-11-02","2020-07-23","2020-07-23","2020-07-23","2020-07-23","2020-07-23","2020-07-23","2020-08-18","2020-09-03","2021-08-06","2021-09-28","2020-09-09","2020-09-09","2020-09-09","2020-09-19","2020-09-15","2021-09-17","2021-10-12","2021-11-02","2021-11-02","2021-12-10","2021-12-10","2020-07-23","2020-10-20","2020-09-19","2020-09-19","2020-09-19","2020-10-08","2020-08-13","2020-09-10","2020-09-15","2020-09-15","2020-09-19","2021-10-21"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"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":[]},{"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":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","76385011250","CARVEDILOL                                                            ","12.5MG","180","Select","Select",""],["","69452015120","VITAMIN D                                                             ","50000UNT","6","Select","Select",""],["","69097094312","GABAPENTIN                                                            ","300MG","270","Select","Select",""],["","13668013501","ESCITALOPRAM OXALATE                                                  ","5MG","90","Select","Select",""],["","68180072103","AMLODIPINE BESYLATE                                                   ","10MG","90","Select","Select",""],["","00469260230","MYRBETRIQ                                                             ","50MG","90","Select","Select",""],["","59746038406","TERAZOSIN HYDROCHLORIDE                                               ","2MG","90","Select","Select",""],["","68180052001","LISINOPRIL\/HYDROCHLOROTHIAZIDE                                        ","20-25MG","90","Select","Select",""],["","00378392593","FEBUXOSTAT                                                            ","40MG","90","Select","Select",""],["","60505294509","EZETIMIBE                                                             ","10MG","90","Select","Select",""],["","62175061743","PANTOPRAZOLE SODIUM                                                   ","40MG","90","Select","Select",""],["","69238199107","DIGOXIN                                                               ","0.125MG","90","Select","Select",""],["","00093317431","ALBUTEROL SULFATE HFA                                                 ","HFA","8","Select","Select",""],["","00054418425","DEXAMETHASONE                                                         ","4MG","-30","Select","Select",""],["","00093811956","FAMCICLOVIR                                                           ","500MG","-21","Select","Select",""],["","00832054111","BUMETANIDE                                                            ","1MG","30","Select","Select",""],["","51862024160","AMIODARONE HYDROCHLORIDE                                              ","200MG","-90","Select","Select",""],["","61442011201","ACYCLOVIR                                                             ","400MG","60","Select","Select",""],["","68180071160","CEFDINIR                                                              ","300MG","20","Select","Select",""],["","59746011506","PROCHLORPERAZINE MALEATE                                              ","10MG","30","Select","Select",""],["","53746010901","HYDROCODONE\/ACETAMINOPHEN                                             ","5-325MG","15","Select","Select",""],["","65862053750","LEVOFLOXACIN                                                          ","500MG","5","Select","Select",""],["","49281012065","FLUZONE HIGH-DOSE PF 2020-2021                                        ","PF 20-21","1","Select","Select",""],["","68180012202","CEPHALEXIN                                                            ","500MG","20","Select","Select",""],["","47781030301","NITROFURANTOIN MONOHYDRATE\/MACROCRYSTALS                              ","100MG","14","Select","Select",""],["","65862007601","CIPROFLOXACIN HYDROCHLORIDE                                           ","250MG","20","Select","Select",""],["","75826011410","PHENAZOPYRIDINE HYDROCHLORIDE                                         ","100MG","60","Select","Select",""],["","59746038506","TERAZOSIN HCL                                                         ","5MG","90","Select","Select",""],["","00093310905","AMOXICILLIN                                                           ","500MG","12","Select","Select",""],["","65162068090","PROMETHAZINE HYDROCHLORIDE\/DEXTROMETHORPHAN HYDROBROMIDE              ","DM","120","Select","Select",""],["","80777027310","MODERNA COVID-19 VACCINE                                              ","COVID-19","0","Select","Select",""],["","00378632377","VALSARTAN\/HYDROCHLOROTHIAZIDE                                         ","160-25MG","90","Select","Select",""],["","13668000905","CITALOPRAM HYDROBROMIDE                                               ","10MG","30","Select","Select",""],["","43386035610","HYDROCODONE BITARTRATE\/ACETAMINOPHEN                                  ","5-325MG","20","Select","Select",""]]}},{"a":[]},{"a":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"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":"","a13":""}]}]}