{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MYRTLE A FOSTER","gend":1,"add":"2811 INDIAN NECK ROAD","city":"TAPPAHANNOCK","state":"VA","zip":"22560-9998","dob":"1938-04-13","age":"","mstatus":"","insh":11000135,"cliId":"8KK5AM2XJ64","pno":8042461784,"cno":8042461784,"email":"","ename":"","eno":"","pphy":"BIGGERS, JONATHAN WOODRUFF ","ppno":8047693022,"pcpadd":"11814 King William Rd","pcpcity":"Aylett","pcpstate":"VA","pcpzip":230094103,"pcpcounty":"","pcpid":"P0060286","pcpname":"KING WILLIAM DAWN COMMUNITY DOCTORS","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"2811 INDIAN NECK ROAD","madd2":"","madd3":"","mcity":"TAPPAHANNOCK","mstate":"VA","mzip":"22560-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["I35.0","I36.1","I51.7","J96.01","I50.33","E43","J18.9","I13.0","N18.4","N17.9","Z68.41","K92.2","E11.22","D63.1","D46.9","Z68.39","E78.5","E66.9","Z86.73","R06.02","I10","N18.3","R06.03","I50.31","N18.9","Z79.84","E83.42","I44.0","R94.31","I49.8","I13.2","I50.9","N18.6","R79.89","E11.9","R09.02","R05","R50.9","I34.0","D53.9","D62","R93.2","R93.3","R06.89","J98.11","R06.00","D64.9","N28.9","D50.9","I70.1","Z01.818","K76.9","K86.9","Z01.810","I25.10","I27.20","R93.5","I12.9","Z00.6","Z98.890","Z98.61","M54.2","M10.9","I73.9","D50.0","Z95.2","E66.01","I77.810","J81.1","R60.1","M25.559","R53.1","Z48.812","I50.32","K21.9","E78.00","E46","R32","R26.89","Z79.01","H04.122","Z96.1","R80.9","N26.1","E55.9","N25.81","Z79.82","Z68.36","N18.2","Z71.89","Z71.3","E11.3291","W18.39XA","Y92.013","Z95.5","Z79.899","Z00.00","N63.0","N63.11","R60.0","N63.10","R26.81","Z12.31","Z23","R10.2","W18.30XA","Y93.9","Y92.512","D69.6","E87.0","N18.30","N18.32","L60.2","B35.1","M79.671","H26.492","H40.003","L85.9","R60.9","K22.6","Z82.49","R10.9","K86.2","K20.90","I85.00","K27.9","K44.9","K29.70","G47.30","E86.0","R11.10","K29.01","K56.7","K92.1","R19.4","R11.2","I11.0","I34.2","E78.2","Z01.812","Z20.822","K25.7","K29.80","K31.89"],"date":["2021-07-30","2020-01-10","2021-07-30","2020-01-23","2020-03-11","2020-03-11","2020-01-23","2021-10-25","2021-07-29","2021-09-27","2020-01-29","2021-08-16","2021-10-25","2021-11-18","2021-10-25","2021-10-25","2021-09-07","2020-03-11","2021-08-10","2020-01-15","2021-10-04","2020-09-09","2020-01-08","2020-01-08","2021-10-25","2021-06-24","2020-01-08","2021-08-11","2020-01-08","2020-01-08","2020-01-08","2021-06-24","2020-01-08","2020-01-08","2021-08-10","2020-01-29","2020-01-08","2020-01-08","2020-01-23","2020-01-17","2021-07-29","2020-01-13","2020-01-13","2020-01-13","2020-02-03","2020-01-13","2021-07-30","2020-01-21","2020-01-29","2020-01-15","2020-01-15","2020-01-15","2020-01-15","2020-01-15","2021-10-25","2020-01-20","2020-01-21","2020-02-28","2020-01-22","2020-01-25","2020-01-28","2019-01-23","2020-05-21","2021-09-07","2021-09-07","2021-10-25","2021-10-25","2020-01-23","2020-01-23","2020-01-29","2020-01-29","2020-02-28","2020-03-11","2021-10-25","2021-10-25","2020-02-03","2020-02-03","2020-01-29","2020-01-29","2020-02-03","2018-02-08","2021-06-02","2021-09-27","2021-07-29","2021-09-27","2020-07-22","2021-06-24","2021-10-04","2018-02-15","2021-01-25","2021-01-25","2020-02-19","2020-02-28","2020-02-28","2020-02-28","2021-08-10","2020-02-28","2019-05-22","2020-06-02","2021-05-27","2019-05-13","2020-05-21","2020-06-19","2021-01-25","2019-11-01","2019-11-01","2019-11-01","2019-11-01","2021-09-27","2021-01-11","2021-11-18","2021-09-27","2021-01-25","2021-03-12","2021-03-12","2021-06-02","2021-06-02","2021-07-09","2021-07-09","2021-07-29","2021-06-24","2021-07-29","2021-07-29","2021-07-29","2021-07-29","2021-07-29","2021-10-25","2021-07-29","2021-07-29","2021-07-29","2021-07-30","2021-08-10","2021-08-10","2021-10-27","2021-08-25","2021-08-10","2021-06-14","2021-06-25","2021-10-25","2021-10-21","2021-10-21","2021-10-25","2021-10-25","2021-10-27"],"priorHcc":["","","","","","","","","","","","","",null,"","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",null,"","","","","","","","","","","","","","","","","","","","","","","","","","",null,"","","","","","","","","","","","","","","","","","","","","","",null,"","","","","","","","","",null]}},{"a":[]}]},{"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":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","60505009400","DOXAZOSIN","TAB 2MG","","Select","Select",""],["","67877019910","AMLODIPINE","TAB 10MG","","Select","Select",""],["","49884012401","LABETALOL","TAB 300MG","","Select","Select",""],["","53489015605","ALLOPURINOL","TAB 100MG","","Select","Select",""],["","378021610","FUROSEMIDE","TAB 40MG","","Select","Select",""],["","57237010199","METOPROL TAR","TAB 50MG","","Select","Select",""],["","43547036009","LOSARTAN POT","TAB 25MG","","Select","Select",""],["","56151146304","TRUE METRIX","TES GLUCOSE","","Select","Select",""],["","60505014201","GLIPIZIDE","TAB 10MG","","Select","Select",""],["","378064110","PREDNISONE","TAB 10MG","","Select","Select",""],["","23155000201","HYDRALAZINE","TAB 25MG","","Select","Select",""],["","378581577","VALSARTAN","TAB 320MG","","Select","Select",""],["","93720298","PRAVASTATIN","TAB 40MG","","Select","Select",""],["","6011231","JANUVIA","TAB 50MG","","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","68180072103","AMLODIPINE ","TAB 10MG","90","Select","Select",""],["","23155000201","HYDRALAZINE ","TAB 25MG","270","Select","Select",""],["","93206901","DOXAZOSIN ","TAB 2MG","30","Select","Select",""],["","65862020190","LOSARTAN ","TAB 25MG","30","Select","Select",""],["","53489015605","ALLOPURINOL ","TAB 100MG","60","Select","Select",""],["","49884012401","LABETALOL ","TAB 300MG","60","Select","Select",""],["","378021610","FUROSEMIDE ","TAB 40MG","30","Select","Select",""],["","60505014201","GLIPIZIDE ","TAB 10MG","180","Select","Select",""],["","57237010199","METOPROL ","TAB 50MG","180","Select","Select",""],["","93720210","PRAVASTATIN ","TAB 40MG","90","Select","Select",""],["","56151146304","TRUE ","TES GLUCOSE","100","Select","Select",""],["","55111015810","OMEPRAZOLE ","CAP 20MG","90","Select","Select",""],["","378064110","PREDNISONE ","TAB 10MG","21","Select","Select",""],["","6011231","JANUVIA ","TAB 50MG","30","Select","Select",""],["","378581577","VALSARTAN ","TAB 320MG","30","Select","Select",""],["","169406012","VICTOZA ","18MG\/3ML","6","Select","Select",""],["","169185550","NOVOFINE ","32GX4MM","100","Select","Select",""],["","65862020190","LOSARTAN","25MG","30","Select","Select",""],["","00169406012","VICTOZA","18MG\/3ML","6","Select","Select",""],["","57664050658","METOPROL","25MG","180","Select","Select",""],["","56151146304","TRUE","GLUCOSE","100","Select","Select",""],["","00169185550","NOVOFINE","32GX4MM","100","Select","Select",""],["","65862039010","ONDANSETRON","4MG ODT","10","Select","Select",""],["","62175061743","PANTOPRAZOLE","40MG","90","Select","Select",""],["","00032301613","CREON","36000UNT","200","Select","Select",""],["","62175061743","PANTOPRAZOLE ","TAB 40MG","90","Select","Select",""],["","00032301613","CREON ","CAP 36000UNT","200","Select","Select",""],["","65862039010","ONDANSETRON ","TAB 4MG ODT","10","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}