{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"F NELLANAHCNI","gend":0,"add":"       ENAL NOSTREBLUC 99                         ","city":"CASTLEWOOD               ","state":"VA","zip":"24224-9998","dob":"1958-03-09","age":"","mstatus":"","insh":"00113767","cliId":"","pno":"9767296494","cno":2767949569,"email":"","ename":"","eno":"","pphy":"EASTON, BRIAN T","ppno":4232395141,"pcpadd":"4848 FORT HENRY DR,PO BOX 741","pcpcity":"Kingsport","pcpstate":"TN","pcpzip":376633347,"pcpcounty":"","pcpid":"","pcpname":"HOLSTON MEDICAL GROUP PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"99 CULBERTSON LANE                                ","madd2":"                                                  ","madd3":"","mcity":"CASTLEWOOD               ","mstate":"VA","mzip":"24224-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["T78.40XA","F41.9","F32.9","N40.0","K21.9","G47.00","M15.9","F29","F20.9","R42","R07.0","Z20.822","Z59.2","Z51.81","Z79.899","K29.50","K22.70","K29.70","K20.80","K44.9","R13.10","K20.90","F17.210","K29.00","F51.04","F33.1","F13.20","J43.1","J30.89","F41.1","M15.0","F20.3","J44.1","Z12.11","R11.10","F15.20","T43.595A","I10","Z72.0","J30.9","T88.7XXA","Y92.9","T43.505A","Z23","R53.83","R10.13","G89.29","Z12.5","J18.1","J96.01","J18.9","J69.0","J44.0","E87.1","R13.14","E87.6","D64.9","R41.82","R53.1","R51.9","J44.9","R06.02","Z99.81","R91.8","F17.200","R13.19","Z98.890","K31.89","K22.89","I50.9","R94.31","K29.30","E78.2","Z00.00"," ","H40.53X4","H35.89","H25.13"],"date":["2020-01-09","2022-03-03","2020-01-09","2022-12-07","2022-12-07","2020-01-09","2020-01-09","2020-01-09","2022-11-03","2020-01-10","2021-01-19","2022-02-28","2022-11-03","2022-03-15","2022-03-03","2022-03-03","2022-03-29","2022-03-03","2022-03-03","2022-03-03","2022-03-15","2022-03-03","2022-04-06","2022-03-03","2022-12-07","2022-12-07","2022-08-31","2022-12-07","2022-08-31","2022-12-07","2020-03-05","2022-12-07","2020-03-05","2022-07-19","2021-04-07","2022-12-07","2019-09-17","2019-12-06","2022-02-28","2019-12-05","2019-09-17","2019-09-17","2019-09-17","2020-10-27","2020-11-05","2020-12-03","2020-12-03","2022-05-06","2022-02-28","2022-03-03","2022-03-15","2022-02-28","2022-02-28","2022-03-03","2022-03-03","2022-05-06","2022-03-03","2022-02-28","2022-02-28","2022-02-28","2022-03-03","2022-02-28","2022-02-28","2022-02-28","2022-03-02","2022-07-19","2022-03-02","2022-03-03","2022-03-03","2022-03-03","2022-03-06","2022-03-29","2022-05-06","2022-04-06","2022-12-07","2022-11-01","2022-11-01","2022-08-10"],"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":[["","68382000105","PAROXETINE","TAB 40MG","28","Select","Select",""],["","00603243832","BENZTROPINE","TAB 1MG","56","Select","Select",""],["","16729014201","CLOZAPINE","TAB 100MG","56","Select","Select",""],["","68382080605","TRAZODONE","TAB 100MG","56","Select","Select",""],["","59762040105","SUCRALFATE","TAB 1GM","84","Select","Select",""],["","68462039710","OMEPRAZOLE","CAP 40MG","28","Select","Select",""],["","68382013201","TAMSULOSIN","CAP 0.4MG","28","Select","Select",""],["","00591024110","LORAZEPAM","TAB 1MG","84","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","28","Select","Select",""],["","70069005101","DORZOL\/TIMOL","SOL 22.3-6.8","10","Select","Select",""],["","61314063705","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0.30","Select","Select",""],["","64380080307","RANITIDINE","TAB 150MG","28","Select","Select",""],["","70069023101","BRIMONIDINE","SOL 0.2% OP","5","Select","Select",""],["","33332032203","AFLURIA","INJ 2022-23","0.5","Select","Select",""],["","43386006019","GAVILYTE-C","SOL ","4,000.00","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","68001036206","CEFDINIR","CAP 300MG","4.00","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}