{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ELLENAJNAGROM L","gend":1,"add":"FILAH 807TEERTS XA","city":"EMPORIA","state":"VA","zip":"23847-1328","dob":"1981-01-30","age":"","mstatus":"","insh":"00119610","cliId":"","pno":"3643443167","cno":"","email":"","ename":"","eno":"","pphy":"ANDERSON, MICHAEL S","ppno":"4346346101          ","pcpadd":"6 Doctors Dr, ","pcpcity":"Emporia","pcpstate":"VA","pcpzip":"238471240","pcpcounty":"","pcpid":"","pcpname":"EMPORIA MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"708 HALIFAX STREET","madd2":"","madd3":"","mcity":"EMPORIA","mstate":"VA","mzip":"23847-1328","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G56.01","G56.02","M17.11","M25.561","I31.3","I10","R00.0","E66.9","Z72.0","A59.00","N92.6","L29.3","M50.021","G95.9","M50.022","B37.3","E04.9","E04.2","Z68.37","E07.89","E04.1","R00.2","J90","M47.12","Z13.6","F31.9","M54.2","R29.898","R82.90","Z01.419","Z68.41","E66.01","E55.9","R25.2","E66.09","E78.5","Z79.899","J02.9","L25.9","A41.9","J18.9","I21.3","R06.02","R07.9","R50.9","F17.210","J44.9","R07.89","I30.9","B37.0","I31.1","G47.33","D50.9","N70.11","R91.1","R59.0","K59.00","R74.8","Z79.82","J98.4","J98.11","R94.31","R10.9","R06.00","R91.8","Z11.3","I31.9","Z71.6","H10.33","J01.90","G45.9","G45.3","N39.0","R42","H54.7","R09.89","I65.22","Z01.812","I07.1","I37.1","N89.8","K65.8","M06.4","Z79.84","N76.0","Z68.38","F41.9","R10.11","Z79.1","Z82.49","Z83.3","Z83.49","R73.03","Z73.3","R11.0","Z68.39","R23.2","Z01.411","G56.03","J20.9","R73.09","Z20.828","L30.9","L29.8","L81.0","R05","R19.7","J06.9","B34.9","I51.7","M25.549","J30.2","R73.9","M54.9","M50.320","I30.1","I31.4","F17.200","G89.29","D64.9","I34.0","I36.1","I95.9","I31.8","Z46.82","J91.8","E87.6","E05.90","E07.9","I25.10","Z68.35","R93.8","R07.1","R06.83","N64.3","N76.1","L70.0","L72.8","L85.8"],"date":["2022-01-10","2021-10-06","2020-03-03","2020-02-25","2021-02-17","2021-04-05","2021-02-17","2021-02-17","2021-02-17","2020-04-13","2020-03-04","2020-03-04","2018-03-05","2018-04-03","2018-03-05","2018-03-08","2018-04-12","2021-08-19","2022-01-10","2018-03-09","2020-06-25","2020-08-20","2018-08-22","2018-03-14","2018-03-14","2022-01-20","2021-04-05","2018-03-21","2021-04-14","2020-09-29","2021-04-05","2022-01-10","2021-04-05","2021-04-05","2021-11-22","2021-04-05","2021-11-22","2019-02-11","2018-04-11","2018-04-12","2018-04-18","2018-04-12","2018-04-12","2018-04-12","2018-04-12","2022-01-10","2018-04-12","2019-01-11","2018-04-15","2018-04-12","2018-04-12","2018-04-12","2018-11-02","2018-04-12","2018-08-22","2018-04-12","2019-09-23","2018-04-15","2021-08-19","2018-04-12","2018-04-12","2018-04-12","2018-04-12","2018-04-12","2018-04-12","2021-04-14","2019-09-23","2018-04-18","2018-04-30","2020-05-12","2020-06-25","2020-06-03","2020-06-08","2020-06-30","2020-06-03","2020-06-03","2020-06-25","2020-06-25","2020-06-25","2020-06-25","2019-12-11","2018-07-25","2018-07-25","2018-07-25","2018-08-01","2021-11-22","2021-08-20","2021-09-02","2021-08-19","2021-08-19","2021-08-19","2021-08-19","2021-08-20","2021-08-20","2021-09-02","2021-08-20","2020-09-29","2020-09-29","2022-01-10","2021-11-22","2020-12-01","2021-12-31","2020-01-07","2020-01-07","2022-03-01","2018-02-16","2020-02-10","2018-01-13","2018-01-13","2018-02-16","2020-01-27","2018-02-06","2018-02-05","2018-02-06","2018-02-05","2018-02-06","2018-02-06","2018-02-22","2018-02-06","2018-02-22","2018-02-06","2018-02-06","2018-02-08","2018-02-07","2018-02-07","2018-02-22","2018-02-22","2018-02-22","2018-02-22","2018-02-22","2018-02-22","2018-02-22","2018-02-20","2018-02-20","2022-02-22","2022-02-22","2022-03-01","2022-03-01","2022-03-01"],"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":[["","50742061610","METOPROL","TAB 50MG ER","90.00","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30.00","Select","Select",""],["","68382097001","CHLORTHALID","TAB 25MG","45.00","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","90.00","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","90.00","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","4.00","Select","Select",""],["","59310057922","PROAIR","AER ","8.50","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20.00","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","30.00","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","20.00","Select","Select",""],["","69097083305","SERTRALINE","TAB 25MG","30.00","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","15.00","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6.00","Select","Select",""],["","00254200801","COLCHICINE","TAB 0.6MG","90.00","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","21.00","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","10.00","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","20.00","Select","Select",""],["","16729020001","BUSPIRONE","TAB 5MG","30.00","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20.00","Select","Select",""],["","00228202750","ALPRAZOLAM","TAB 0.25MG","40.00","Select","Select",""],["","45802006435","TRIAMCINOLON","CRE 0.001","45.00","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","30.00","Select","Select",""],["","68180030360","CEFUROXIME","TAB 500MG","20.00","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","24.00","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":["",""]}},{"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":""}]}]}