{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"HT YDUJNOSPMO","gend":1,"add":"          EVA TRUOC N 223                         ","city":"COVINGTON                ","state":"VA","zip":"24426-9998","dob":"1946-10-08","age":"","mstatus":"","insh":"00112531","cliId":"","pno":"5904553768","cno":5406913314,"email":"","ename":"","eno":"","pphy":"HENDERSON, ROBERT J","ppno":5408626750,"pcpadd":"200 ARH LN STE 800,STE 800","pcpcity":"Covington","pcpstate":"VA","pcpzip":244266254,"pcpcounty":"","pcpid":"","pcpname":"PATRICIA W HENDERSON DO PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APT C                                             ","add3":"","madd1":"322 N COURT AVE                                   ","madd2":"APT C                                             ","madd3":"","mcity":"COVINGTON                ","mstate":"VA","mzip":"24426-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M17.11","J11.1","R05","R63.4","Z96.60","Z47.1","H25.12","Z96.651","N81.11","N81.6","Z12.4","Z01.419","F33.1","K76.9","N28.9","F41.8","K21.9","E78.5","L98.9","M25.561","M25.661","K52.9","M81.0","A41.9","N17.9","R19.7","I95.9","Z66","I50.40","E87.2","R65.20","I11.0","E87.6","D64.9","Z79.82","Z85.3","Z90.11","Z90.49","R11.2","R53.1","I49.8","R94.31","I50.9","I10","K44.9","R33.9","I70.0","R06.02","I95.89","E86.1","R33.8","N28.89","F41.9","F32.9","Z47.33","R91.1","I25.10","I70.90","R10.9","R39.15","K59.00","R10.30","R10.31","K57.90","D12.8","K64.8","Z71.9","D37.4","K29.01","K21.0","K29.51","K22.8","K25.9","K63.89","K63.5","E78.00","K62.89","K29.61","K29.50","K22.10","M25.569","K20.9","K29.80","K57.10","H35.371","H02.831","Z96.1","Z12.11","K31.84","K57.30","Z11.59","K50.90","L82.1","M25.562","M17.12","E78.1","B35.1","F40.10","M19.072","G47.00","R30.9","F41.1","Z23","K29.70","M19.90","Z20.828","K31.89","Z00.00","Z12.39","N81.10","F29","R41.0","N30.00","Z87.891","E86.0","Z74.3","R55","Z87.440","F32.3","E43","Z68.1","E66.3","M17.10","Z88.2","Z88.8","Z85.048","I07.1","F23","Z98.890","F33.3","R45.851","I12.9","N18.30","I49.3","R41.3","R73.09","H70.12","Z90.89","H66.90","H61.22","R00.2","R00.9","Z01.818","G89.29","I08.0","E83.30","E83.39","Z79.899","M17.0","Z79.01","Z79.891","R26.89","R73.9","H90.3"," "],"date":["2019-01-07","2020-01-26","2020-01-26","2019-07-01","2019-02-06","2019-12-09","2018-02-08","2019-12-09","2021-02-23","2021-02-23","2021-02-23","2021-02-23","2020-11-09","2019-03-01","2019-03-01","2022-06-22","2022-06-22","2022-10-12","2021-06-02","2019-03-04","2019-03-04","2020-11-02","2020-04-20","2020-04-21","2020-04-23","2020-10-28","2020-10-28","2020-04-20","2020-05-04","2020-04-20","2020-04-21","2020-05-04","2020-10-28","2020-04-20","2020-10-27","2020-11-09","2020-11-09","2020-11-09","2020-04-20","2020-04-20","2020-04-21","2020-04-21","2020-04-23","2022-10-12","2020-09-18","2020-04-21","2020-04-21","2020-04-21","2020-04-21","2020-04-21","2020-04-22","2020-11-09","2020-11-09","2020-10-10","2019-12-09","2019-11-15","2019-05-17","2019-05-17","2020-09-18","2020-05-18","2020-05-25","2020-05-25","2020-05-25","2020-10-27","2019-07-01","2019-07-01","2019-07-01","2019-06-11","2019-06-11","2020-09-15","2019-06-11","2019-06-11","2019-07-01","2019-07-01","2019-06-11","2020-09-15","2019-06-11","2019-06-11","2019-06-11","2019-06-11","2018-06-22","2020-09-18","2019-07-01","2019-07-01","2018-07-16","2018-07-16","2018-07-16","2020-07-24","2020-09-24","2020-07-24","2020-07-21","2020-07-24","2021-07-30","2018-08-08","2018-08-08","2019-11-15","2019-08-12","2018-08-22","2019-09-04","2020-11-12","2020-09-09","2020-09-09","2020-09-09","2020-09-15","2020-09-15","2020-10-23","2020-09-18","2020-10-05","2020-10-05","2020-10-05","2020-10-28","2020-10-10","2020-10-10","2020-10-10","2020-10-10","2020-10-10","2020-10-28","2020-10-22","2020-10-27","2020-10-23","2020-10-23","2020-10-23","2020-10-23","2020-10-23","2020-10-27","2020-10-27","2020-10-27","2020-10-25","2020-11-09","2020-11-09","2020-10-28","2020-10-27","2020-11-02","2020-10-27","2018-11-09","2019-11-15","2022-11-16","2022-11-16","2019-11-25","2019-11-25","2018-12-06","2018-12-06","2018-12-06","2018-12-07","2018-12-11","2018-12-18","2018-12-18","2018-12-20","2018-12-26","2018-12-26","2018-12-26","2022-03-02","2022-03-31","2022-06-23","2022-11-16"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","67877022210","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","29300039710","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00093220405","METOCLOPRAM","TAB 5MG","60","Select","Select",""],["","55111015930","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","13107000334","MIRTAZAPINE","TAB 30MG","90","Select","Select",""],["","63304007610","POT  CHLORIDE","TAB 10MEQ ER","60","Select","Select",""],["","63304090190","FENOFIBRATE","TAB 160MG","90","Select","Select",""],["","68462047101","POT  CL MICRO","TAB 10MEQ ER","60","Select","Select",""],["","00115180302","HYDROXYZ","CAP 25MG","120","Select","Select",""],["","43547028010","ESCITALOPRAM","TAB 5MG","90","Select","Select",""],["","67877024901","QUETIAPINE","TAB 50MG","90","Select","Select",""],["","68382003510","VENLAFAXINE","CAP 75MG ER","90","Select","Select",""],["","50383090110","HC\/ACET","SOL OTIC","10","Select","Select",""],["","49281012165","FLUZONE","INJ 2021-22","0.70","Select","Select",""],["","65162027110","SMZ-TMP","TAB 400-80MG","10","Select","Select",""],["","55111015330","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","8","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","12","Select","Select",""],["","68645055154","LISINOPRIL","TAB 5MG","90","Select","Select",""],["","50111043303","TRAZODONE","TAB 50MG","30","Select","Select",""],["","80777028299","MODERNA","INJ BA4\/BA5","0.5","Select","Select",""],["","66758017092","KLOR-CON","TAB 10MEQ ER","270","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","42","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 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":""}]}]}