{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEANNA   M AISNER","gend":1,"add":"1941 SHELLEYS ROAD","city":"BRISTOL                       ","state":"VA","zip":"24202-6524","dob":"1983-04-15","age":"","mstatus":"","insh":3168500,"cliId":"","pno":2767911047,"cno":"","email":"","ename":"","eno":"","pphy":"ANDREWS, ROY R","ppno":8042718990,"pcpadd":"2195 Euclid Ave,Ste 6","pcpcity":"Bristol                       ","pcpstate":"VA","pcpzip":242013655,"pcpcounty":"","pcpid":"","pcpname":"TWIN CITY MEDICAL CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":"","add2":"1941 SHELLEYS ROAD","add3":"","madd1":"1941 SHELLEYS ROAD","madd2":"UNIT 21","madd3":"","mcity":"BRISTOL                       ","mstate":"VA","mzip":"24202-6524","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K80.00","M41.9","M51.26","N94.89","R10.84","N80.9","G89.21","L90.5","M17.0","M46.1","G89.29","R10.11","K80.20","K80.10","J45.909","G43.909","K21.9","G62.9","G89.4","M79.7","M54.2","M54.5","E78.5","F17.200","F41.9","Z85.828","Z79.899","Z01.812","Z01.818","K43.0","K43.2","F17.210","K43.9","Z98.890","Z87.19","F31.11","F41.1","G47.00","F90.0","R31.9","R74.8","R79.89","E78.2","K76.0","R12","N81.10","R11.2","E04.9","R73.9","Z78.0","F33.0","J32.9","G47.09","M54.41","E55.9","B96.89","F32.9","M48.062","Z79.891","Z51.81","M54.16","J06.9","R50.9","J01.80","Z86.19","Z92.29","G43.109","F90.1","U07.1","Z03.818","J98.8","R05.8","M48.07","K42.9","R19.09","M48.061","M70.61","M70.62","M94.0","R52","J02.9","R09.81","R11.0","J01.00","R05","Z87.891","S62.306A","S62.336A","F33.1","S62.336D","F11.20","R68.89","A08.4"],"date":["2020-09-01","2020-09-01","2022-02-14","2020-09-01","2021-04-29","2020-09-01","2020-09-01","2020-09-01","2020-09-01","2020-09-01","2022-02-14","2021-03-22","2020-09-17","2020-09-17","2020-09-17","2020-09-17","2020-09-17","2020-09-17","2020-09-17","2021-08-04","2021-08-04","2020-09-17","2021-06-17","2020-09-17","2021-08-04","2020-09-17","2021-06-17","2020-09-17","2020-10-23","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2021-04-29","2021-04-29","2022-03-15","2021-01-26","2021-08-17","2021-01-26","2021-03-17","2021-04-29","2021-03-17","2021-03-17","2021-03-17","2021-03-22","2021-04-29","2021-04-29","2021-06-17","2021-06-17","2021-06-17","2021-08-17","2021-08-04","2021-08-04","2022-02-14","2021-08-04","2021-08-04","2021-08-04","2021-08-18","2021-08-18","2021-08-18","2021-10-11","2021-10-28","2021-10-28","2021-10-28","2021-11-02","2021-11-02","2021-11-02","2022-03-15","2021-12-27","2021-12-27","2021-12-27","2022-01-06","2022-02-14","2022-02-14","2022-02-14","2020-03-16","2020-04-07","2019-06-11","2019-01-19","2020-02-14","2020-01-28","2020-02-14","2019-04-09","2019-04-14","2020-02-14","2020-02-10","2019-08-15","2019-08-16","2019-09-18","2019-09-20","2020-01-06","2020-02-14","2020-01-28"],"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":{"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":[["","00054018913","BUPREN\/NALOX","SUB 8-2MG","14.00","Select","Select",""],["","31722053401","METHOCARBAM","TAB 750MG","20.00","Select","Select",""],["","43598065530","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","30.00","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","68645013054","FLUOXETINE","CAP 20MG","30","Select","Select",""],["","16714008210","HYDROXYZ","TAB 25MG","90","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","81131007403","MELATONIN","TAB 10MG","30","Select","Select",""],["","33342008841","RIZATRIPTAN","TAB 10MG","12","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","60","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","28","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","12","Select","Select",""],["","00591350904","CLONIDINE","DIS 0.2\/24HR","4","Select","Select",""],["","00093216568","NALOXONE","SPR ","2.00","Select","Select",""],["","67877022310","GABAPENTIN","CAP 300MG","180","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","51672400501","CARBAMAZEPIN","TAB 200MG","60","Select","Select",""],["","68180044801","QUETIAPINE","TAB 200MG","60","Select","Select",""],["","00406831501","MORPHINE","TAB 15MG ER","60","Select","Select",""],["","49281072110","FLUBLOK","INJ 2021-22","0.5","Select","Select",""],["","60505283303","ATOMOXETINE","CAP 40MG","30","Select","Select",""],["","60505016809","PRAVASTATIN","TAB 10MG","30","Select","Select",""],["","00406012505","HYDROCO\/APAP","TAB 10-325MG","120","Select","Select",""],["","00143928501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","68462080101","METHADONE","TAB 10MG","135","Select","Select",""],["","62756018388","OXCARBAZEPIN","TAB 150MG","60","Select","Select",""],["","00527058610","DICYCLOMINE","CAP 10MG","120","Select","Select",""],["","00069046903","CHANTIX","PAK 1MG","56","Select","Select",""],["","60432060416","PROMETHAZINE","SYP DM","118","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","16729013616","CLONAZEPAM","TAB 0.5MG","30","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","6","Select","Select",""],["","00054350049","LIDOCAINE","SOL 2% VISC","200","Select","Select",""],["","62332041510","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","00363031034","WAL-TUSSIN","SYP 100\/5ML","236","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","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":""}]}]}