{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"A IROLDEER ","gend":1,"add":"            TS WOLLIW 803                         ","city":"GATE CITY                ","state":"VA","zip":"24251-9998","dob":"1969-08-23","age":"","mstatus":"","insh":"00114403","cliId":"","pno":"8432401120","cno":4239676197,"email":"","ename":"","eno":"","pphy":"ARNETTE, BRYAN THOMAS","ppno":2763865980,"pcpadd":"1754 US HIGHWAY 23 N,","pcpcity":"Weber City","pcpstate":"VA","pcpzip":242907071,"pcpcounty":"","pcpid":"","pcpname":"HOLSTON MEDICAL GROUP PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"APT 101                                           ","add3":"","madd1":"PO BOX 55                                         ","madd2":"                                                  ","madd3":"","mcity":"GATE CITY                ","mstate":"VA","mzip":"24251-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.9","J06.9","M32.9","F33.9","Z00.00","Z12.31","F17.200","Z99.89","Z79.82","Z79.51","I10","K21.9","F41.9","G31.9","D50.9","Z79.899","K70.9","F11.20","J44.1","M51.36","Z23","F10.120","R06.02","R45.1","R45.0","F41.0","F17.210","L93.0","Z99.81","R06.2","R07.9","J43.9","R09.89","R17","K70.40","M54.9","R41.82","R53.1","S22.31XA","W19.XXXA","S22.009A","K76.0","R16.0","R74.0","F10.20","M54.6","R26.2","M79.89","R00.0","R60.9","S40.022A","S40.021A","L53.9","F10.11","G62.9","L84","R94.5","D69.6","E72.20","L02.92","L97.521","M25.775","M79.672","B35.1","L60.3","B35.3","K70.10","R73.9","M25.559","M25.552","M79.675","M79.674","M20.42","M20.41","M20.22","M20.21","Z28.21","Z53.20","G47.00","M47.816","K92.2","D64.9","L02.13","R55","K80.20","M54.50","G89.29"," "],"date":["2022-05-17","2019-02-07","2022-03-22","2022-07-13","2022-10-04","2022-04-19","2022-10-04","2021-02-15","2021-02-15","2021-02-15","2022-10-04","2022-05-17","2021-02-15","2021-02-15","2022-05-17","2021-06-14","2022-10-04","2022-05-17","2020-03-09","2020-03-09","2022-10-04","2021-05-05","2021-05-05","2021-05-05","2021-05-05","2021-05-05","2022-10-04","2021-05-05","2021-05-05","2021-05-05","2021-05-05","2022-07-13","2022-04-05","2019-05-17","2020-06-08","2019-05-14","2019-05-14","2022-05-16","2019-05-14","2019-05-14","2019-05-14","2019-05-14","2019-05-14","2019-08-14","2019-05-14","2019-05-14","2019-05-14","2019-05-14","2020-09-08","2019-05-14","2019-05-14","2019-05-14","2018-05-18","2019-07-31","2019-07-31","2020-10-15","2019-08-21","2021-06-28","2021-12-22","2021-06-28","2020-11-10","2020-06-29","2020-10-30","2021-08-10","2021-08-10","2020-06-29","2021-07-14","2021-07-26","2021-07-26","2021-07-26","2021-08-10","2021-08-10","2021-08-10","2021-08-10","2020-09-03","2020-09-03","2021-09-22","2021-09-22","2022-04-19","2022-03-22","2022-05-26","2022-05-26","2022-05-03","2022-05-17","2022-05-16","2022-07-13","2022-07-13","2022-10-04"],"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":[["","00069047103","CHANTIX","PAK 0.5& 1MG","53","Select","Select",""],["","62037059705","CARTIA","CAP 120\/24HR","30","Select","Select",""],["","43547035411","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","00172392680","DIAZEPAM","TAB 5MG","90","Select","Select",""],["","42571012290","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","00172409780","BACLOFEN","TAB 20MG","40","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","53746054205","POT  CHLORIDE","CAP 10MEQ ER","30","Select","Select",""],["","00173088710","TRELEGY","AER ELLIPTA","60","Select","Select",""],["","51991074710","DULOXETINE","CAP 30MG","90","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","90","Select","Select",""],["","16714033002","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","16714074703","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","50742024890","DILTIAZEM","CAP 120MG ER","30","Select","Select",""],["","00121057716","LACTULOSE","SOL 10GM\/15","473","Select","Select",""],["","50111056003","TRAZODONE","TAB 50MG","30","Select","Select",""],["","16714039102","CEFDINIR","CAP 300MG","20","Select","Select",""],["","31722072610","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","60505082701","IPRATROPIUM","SPR 0.0006","15","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","13","Select","Select",""],["","61874013030","VRAYLAR","CAP 3MG","30","Select","Select",""],["","16714029904","AMOXICILLIN","CAP 500MG","4","Select","Select",""],["","00406012401","HYDROCO\/APAP","TAB 7.5-325","20","Select","Select",""],["","6033530","BELSOMRA","TAB 20MG","30","Select","Select",""],["","16714069211","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","62756051788","CARB\/LEVO","TAB 10-100MG","90","Select","Select",""],["","58160088752","FLUARIX","INJ 2021-22","0.5","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","53746054405","PRIMIDONE","TAB 50MG","60","Select","Select",""],["","45802002146","BETAMETH","LOT 0.0005","60","Select","Select",""],["","47781023063","OXYCOD\/APAP","TAB 10-325MG","90","Select","Select",""],["","42806031205","DOXYCYCL","TAB 100MG","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":["",""],"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":""}]}]}