{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" NORAAYENOOL","gend":0,"add":"RREBKCALB 7001DAOR RETNIW Y","city":"Hurley","state":"VA","zip":"24620-9998","dob":"1955-05-25","age":"","mstatus":"","insh":"10111774","cliId":"","pno":"6567257776","cno":"","email":"","ename":"","eno":"","pphy":"POWERS, WILLIAM T","ppno":2769351146,"pcpadd":"1532 SLATE CREEK RD STE 101,STE 101","pcpcity":"Grundy","pcpstate":"VA","pcpzip":"24614-6975","pcpcounty":"","pcpid":"","pcpname":"BUCHANAN HEALTH CENTER INC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1007 BLACKBERRY WINTER ROAD","madd2":"","madd3":"","mcity":"Hurley","mstate":"VA","mzip":"24620-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D64.9","E11.9","E78.49","E55.9","M54.9","G89.29","M25.559","R51.9","R21","Z79.899","E61.1","R53.83","I25.10","I10","E78.5","Z12.11","Z12.12","F06.4","I20.9","R51","L98.9","L03.114","Z12.5","E78.2"],"date":["2023-03-20","2023-03-20","2023-03-20","2023-03-20","2022-12-22","2022-12-22","2022-12-22","2022-12-22","2022-03-08","2023-03-20","2022-09-27","2022-09-27","2023-06-22","2023-06-22","2022-05-05","2022-10-13","2022-10-13","2023-03-20","2023-03-20","2020-07-23","2022-03-08","2022-03-08","2023-03-20","2023-06-22"],"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":[]},{"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":[["","00603255321","BUT\/APAP\/CAF","CAP CODEINE","90","Select","Select",""],["","65862020330","LOSARTAN POT","TAB 100MG","30","Select","Select",""],["","61442010310","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","16729000617","SIMVASTATIN","TAB 40MG","30","Select","Select",""],["","13668010410","ISOSORB MONO","TAB 30MG ER","30","Select","Select",""],["","69097012715","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00115166103","PROPRANOLOL","TAB 40MG","60","Select","Select",""],["","65862052301","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","59762372003","ALPRAZOLAM","TAB 0.5MG","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","50383074016","ALBUTEROL","SYP 2MG\/5ML","210","Select","Select",""],["","60432060816","PROMETHAZINE","SYP 6.25\/5ML","210","Select","Select",""],["","00143980305","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","70954005920","PREDNISONE","TAB 10MG","48","Select","Select",""],["","31722077805","ACYCLOVIR","TAB 800MG","28","Select","Select",""],["","00591354605","BUT\/ASA\/CAF\/","CAP COD 30MG","90","Select","Select",""],["","65862020330","LOSARTAN","TAB 100MG","30","Select","Select",""],["","13668010410","ISOSORB","TAB 30MG ER","30","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","00603255321","BUT\/APAP\/CAF CAP CODEINE","","90","Select","Select",""],["","65862020330","LOSARTAN POT TAB","100MG","30","Select","Select",""],["","61442010310","DICLOFENAC TAB","75MG DR","60","Select","Select",""],["","16729000617","SIMVASTATIN TAB","40MG","30","Select","Select",""],["","13668010410","ISOSORB MONO TAB","30MG ER","30","Select","Select",""],["","69097012715","AMLODIPINE TAB","5MG","30","Select","Select",""],["","00115166103","PROPRANOLOL TAB","40MG","60","Select","Select",""],["","65862052301","GABAPENTIN TAB","600MG","90","Select","Select",""],["","59762372003","ALPRAZOLAM TAB","0.5MG","30","Select","Select",""],["","67877021905","CEPHALEXIN CAP","500MG","40","Select","Select",""],["","50383074016","ALBUTEROL SYP","2MG\/5ML","210","Select","Select",""],["","60432060816","PROMETHAZINE SYP","6.25\/5ML","210","Select","Select",""],["","00143980305","DOXYCYCL HYC CAP","100MG","20","Select","Select",""],["","70954005920","PREDNISONE TAB","10MG","48","Select","Select",""],["","31722077805","ACYCLOVIR TAB","800MG","28","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}