{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" H   NERRAWRJ HSUBMIW","gend":0,"add":"NOSLIP 7172DR LLIMWAS ","city":"STUART","state":"VA","zip":"24171-9998","dob":"1953-02-04","age":"","mstatus":"","insh":"53000910*858","cliId":"","pno":"22\/6720726-9","cno":" ","email":"","ename":"","eno":"","pphy":"MCALEXANDER, LYNDSEY P NP","ppno":"276\/666-0452","pcpadd":"319 HOSPITAL DR STE 202","pcpcity":"MARTINSVILLE","pcpstate":"VA","pcpzip":24112,"pcpcounty":"","pcpid":"","pcpname":"MARTINSVILLE PHYSICIAN PRACTICES LLC","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":" ","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N39.41","N31.9","G35.","F33.1","I10.","F60.9","R35.0","R60.0","R82.90","R30.0","R50.9","U07.1","Z20.822","R51.9","R68.83","G95.9","Z79.899","Z12.11","S72.002A","E78.5","R53.1","G72.9","M84.452A","E87.6","R26.89","F32.9","E03.9","K22.70","R25.2","R53.83","Z00.00","Z23.","Z96.649","F32.A","Z98.890","Z89.222","Z12.5","R26.81","S58.012S","R29.6","M79.89","R06.2","R06.00","R73.9","R73.03","R01.1","M54.2","Z68.33","R06.09","R07.9","R94.31","I88.1","R06.02","I42.2","I87.8","I31.3","I08.1","R94.39","I51.7","Z01.818","I25.10","G54.6","D68.9","I25.118","R45.851","F33.3","F33.2","R39.81","K59.00","R07.89","F39.","F33.9","Z13.220","D64.9"],"date":["2019-12-06","2019-12-06","2022-09-23","2022-07-07","2022-09-23","2021-07-16","2022-10-25","2022-08-25","2021-07-16","2021-07-16","2021-01-22","2021-01-22","2022-07-27","2021-01-22","2021-01-22","2021-10-20","2022-05-23","2022-05-28","2020-05-02","2022-08-30","2022-01-26","2019-09-17","2020-05-03","2020-05-03","2020-05-03","2021-05-20","2021-07-29","2021-07-29","2022-08-30","2021-07-29","2022-07-28","2022-09-23","2021-09-03","2022-08-30","2022-08-30","2022-08-30","2022-09-23","2022-01-26","2022-01-26","2022-01-26","2022-08-30","2022-02-14","2022-08-30","2022-09-23","2022-08-30","2022-08-30","2022-03-15","2022-04-04","2022-06-04","2022-06-04","2022-06-04","2022-03-25","2022-03-25","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-05-23","2022-04-28","2022-04-28","2022-05-23","2022-05-23","2022-05-23","2022-05-23","2022-07-27","2022-07-27","2022-08-18","2022-08-30","2022-08-30","2022-08-25","2022-09-23","2022-09-23","2022-09-23","2022-09-23"],"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":[["","50111056001","TRAZODONE HYDROCHLORIDE","TAB 50MG","90","Select","Select",""],["","00832105415","BACLOFEN","TAB 10MG","-120","Select","Select",""],["","45802005505","TRIAMCINOLONE ACETONIDE","OIN 0.001","454","Select","Select",""],["","55111017915","TIZANIDINE HCL","TAB 2MG","120","Select","Select",""],["","00093081101","NORTRIPTYLINE HCL","CAP 25MG","-90","Select","Select",""],["","55111053401","DIVALPROEX SODIUM ER","TAB 500MG ER","90","Select","Select",""],["","60505392701","GUANFACINE HYDROCHLORIDE","TAB 1MG ER","90","Select","Select",""],["","68645055554","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","68645052354","SERTRALINE HYDROCHLORIDE","TAB 100MG","180","Select","Select",""],["","72205001490","PREGABALIN","CAP 100MG","180","Select","Select",""],["","68180047903","SIMVASTATIN","TAB 20MG","90","Select","Select",""],["","68645052354","SERTRALINE HCL","TAB 100MG","180","Select","Select",""],["","31722070190","LOSARTAN POTASSIUM","TAB 50MG","60","Select","Select",""],["","70069000510","CYANOCOBALAMIN","INJ 1000MCG","4","Select","Select",""],["","67877019705","AMLODIPINE BESYLATE","TAB 2.5MG","90","Select","Select",""],["","42858010201","OXYCODONE\/ACETAMINOPHEN","TAB 5-325MG","14","Select","Select",""],["","68645058259","METFORMIN HYDROCHLORIDE","TAB 500MG","90","Select","Select",""],["","16729018201","HYDROCHLOROTHIAZIDE","TAB 12.5MG","30","Select","Select",""],["","31722088290","ROSUVASTATIN CALCIUM","TAB 5MG","8","Select","Select",""],["","50111091701","TORSEMIDE","TAB 20MG","30","Select","Select",""],["","50742061510","METOPROLOL SUCCINATE ER","TAB 25MG ER","90","Select","Select",""],["","13668010401","ISOSORBIDE MONONITRATE ER","TAB 30MG ER","90","Select","Select",""],["","11845069305","VITAMIN B-12","TAB 1000MCG","90","Select","Select",""],["","05388099945","VITAMIN D3","CAP 400UNIT","90","Select","Select",""],["","68382011314","RISPERIDONE","TAB 0.5MG","30","Select","Select",""],["","00002143380","TRULICITY","INJ 0.75\/0.5","2","Select","Select",""],["","00832532411","POTASSIUM CHLORIDE ER","TAB 10MEQ ER","30","Select","Select",""],["","69292056401","METOLAZONE","TAB 5MG","10","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":""}]}]}