{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TINA   S KRESS","gend":1,"add":"805 EUCLID AVE","city":"LYNCHBURG","state":"VA","zip":"24501-9998","dob":"1969-10-14","age":"","mstatus":"","insh":"900039819*01","cliId":"","pno":"434\/616-3094","cno":"","email":"","ename":"","eno":"","pphy":"RANK, JENNIFER NP","ppno":"434\/385-7578","pcpadd":"113 WIGGINGTON RD SUITE A","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":24502,"pcpcounty":"","pcpid":"","pcpname":"WIGGINGTON ROAD FAMILY PRACTICE INC","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CHARLOTTESVILLE WESTERN","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/385-9756","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.89","F33.1","F43.12","F31.81","I10.","E78.5","I25.10","R73.09","R60.0","H61.23","R22.41","N18.30","J44.9","M25.572","M76.822","M25.571","M79.89","I12.9","D63.1","E55.9","J22.","F17.200","Z00.00","R73.03","N85.7","Z23.","Q74.2","M25.561","N18.3","M32.9","Z12.11","I25.2","F41.1","I73.9","R06.00","G25.81"],"date":["2020-08-25","2021-10-21","2021-10-21","2021-12-06","2021-10-01","2021-08-23","2021-10-01","2021-07-02","2021-08-25","2021-07-02","2021-07-02","2021-11-01","2021-10-01","2021-12-03","2021-12-03","2021-08-18","2021-08-18","2021-11-01","2021-11-01","2021-11-01","2021-05-16","2021-05-16","2021-07-02","2021-08-10","2021-07-02","2021-10-01","2021-12-03","2021-02-25","2020-09-25","2021-08-23","2021-05-23","2021-08-23","2021-08-23","2021-08-23","2021-10-07","2021-10-07"],"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":[["","16729020201","BUSPIRONE HYDROCHLORIDE                                               ","10MG","90","Select","Select",""],["","68180098003","LISINOPRIL                                                            ","10MG","90","Select","Select",""],["","14539067401","HYDROXYZINE PAMOATE                                                   ","25MG","90","Select","Select",""],["","69452015120","VITAMIN D                                                             ","50000UNT","6","Select","Select",""],["","65862022701","LAMOTRIGINE                                                           ","25MG","42","Select","Select",""],["","70710122501","AMITRIPTYLINE HYDROCHLORIDE                                           ","10MG","30","Select","Select",""],["","59779043951","CVS ASPIRIN LOW STRENGTH                                              ","81MG EC","90","Select","Select",""],["","50111043301","TRAZODONE HYDROCHLORIDE                                               ","50MG","30","Select","Select",""],["","50428028724","CVS CALCIUM                                                           ","600MG","180","Select","Select",""],["","59148007280","ABILIFY MAINTENA                                                      ","400MG","1","Select","Select",""],["","20555000500","CALCIUM                                                               ","600MG","180","Select","Select",""],["","70377002911","ATORVASTATIN CALCIUM                                                  ","40MG","90","Select","Select",""],["","70461042010","FLUCELVAX QUADRIVALENT 2020-2021                                      ","2020-21","0","Select","Select",""],["","00173088710","TRELEGY ELLIPTA                                                       ","ELLIPTA","60","Select","Select",""],["","69097052444","DICLOFENAC SODIUM                                                     ","1%","100","Select","Select",""],["","76385011150","CARVEDILOL                                                            ","6.25MG","180","Select","Select",""],["","58160082311","SHINGRIX                                                              ","50\/0.5ML","-1","Select","Select",""],["","71930002643","BROMPHEN\/PSEUDOEPHEDRINE HCL\/DEXTROMETHORPHAN HBR                     ","","240","Select","Select",""],["","59779045839","CVS INDOOR\/OUTDOOR ALLERGY RELIEF                                     ","10MG","20","Select","Select",""],["","00527133850","DOXYCYCLINE MONOHYDRATE                                               ","100MG","14","Select","Select",""],["","69097014260","ALBUTEROL SULFATE HFA                                                 ","HFA","7","Select","Select",""],["","13668013601","ESCITALOPRAM OXALATE                                                  ","10MG","30","Select","Select",""],["","16571020106","DICLOFENAC SODIUM DR                                                  ","75MG DR","60","Select","Select",""],["","43547027010","ROPINIROLE HCL                                                        ","1MG","90","Select","Select",""],["","00186037020","SYMBICORT                                                             ","160-4.5","31","Select","Select",""],["","00310737020","BUDESONIDE\/FORMOTEROL FUMARATE DIHYDRATE                              ","160-4.5","31","Select","Select",""],["","69097015907","MELOXICAM                                                             ","15MG","-30","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":""}]}]}