{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"EMMA M EVANS","gend":1,"add":"214  S SYCAMORE STREET","city":"PETERSBURG","state":"VA","zip":238034237,"dob":"1937-08-01","age":"","mstatus":"","insh":11003297,"cliId":"7XF3GP0DP93","pno":8045061420,"cno":8044902041,"email":"","ename":"","eno":"","pphy":"COHEN, MICHAEL R","ppno":8047998821,"pcpadd":"50 Medical Park Blvd","pcpcity":"Petersburg","pcpstate":"VA","pcpzip":238059275,"pcpcounty":"","pcpid":"P0114244","pcpname":"SOUTHSIDE PRIMARY CARE PETERSBURG","plan":"VPHP - VIRGINIA PREMIER","program":"Medicare","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["Z01.89","I10","D51.8","L60.0","B35.3","B35.1","E10.59","I48.91","Z45.010","I11.9","I25.10","E11.9","M25.50","Z79.4","Z68.32","N39.41","R15.2","H35.341","H43.821","Z96.1","D31.32","I50.22","I35.2","Z95.2","E78.00","Z95.0","Z72.0","Z79.01","D69.6","Z51.81","I11.0","Z95.3","R13.12","Z68.33","R22.2","R60.9","K21.9","K44.9","E11.65","E66.9","J30.9","K29.70","M10.9","R68.2","Z77.22","Z80.9","Z82.49","Z85.43","Z86.73","Z87.891","M35.00","N18.9","I48.20","E87.6","Z79.899","I87.2","L30.3","D51.9","Z23","M19.90","M15.0","I48.0","N28.9","M15.8","R60.0","E08.9","I25.5","R51","I35.9","G56.02","M54.10","M05.9","R51.9","G56.00","M79.641","I50.1","I49.5","I63.30","M19.049","M65.30","R30.0","R35.0","M16.11","M25.751","M25.551","F17.210","Z79.82","M25.552","R00.0","D50.9","G47.33","M10.00","R06.02","R06.83","R40.0","M54.9","S39.012A","M54.5","X58.XXXA","Z85.850","Z90.710","Z95.1","M70.61","M46.1","E87.5","E86.0","R11.2","R19.7","K56.699","R10.11","N17.9","R10.9","I50.9","E78.5","R17","K56.600","M25.562","R26.89","M25.659","R29.898","K56.609","Z00.00","Z13.89","J30.2","I50.20","I51.7","I35.0","I27.20","L98.9","I48.2","Z95.810","Z98.890","M51.37","M47.817","I35.8","B07.8","I35.1","M19.041","M19.042","M79.671","M79.672","M79.642","Z20.828","I47.1","H26.493","Z95.4","M70.62","G93.89","Z68.31"],"date":["2020-07-20","2021-04-19","2021-04-26","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2021-04-22","2021-01-26","2021-02-25","2021-02-25","2021-04-22","2021-02-25","2021-04-12","2021-02-25","2021-04-02","2021-04-02","2021-02-16","2021-02-16","2021-03-19","2021-02-16","2021-04-22","2021-04-12","2021-04-12","2021-04-12","2021-04-22","2019-08-01","2021-04-22","2021-04-19","2021-04-22","2021-04-22","2021-04-22","2020-09-22","2020-11-25","2020-09-22","2020-11-25","2020-09-22","2020-09-22","2020-05-11","2019-09-19","2019-09-19","2019-09-19","2020-12-04","2019-11-13","2019-09-19","2019-09-19","2019-09-19","2019-09-19","2019-09-19","2021-04-12","2020-12-04","2019-09-20","2021-04-12","2020-10-20","2020-10-20","2020-11-17","2018-10-23","2018-11-12","2019-11-13","2018-11-12","2019-11-13","2021-02-25","2019-11-13","2020-11-25","2021-02-25","2021-02-25","2020-11-25","2019-12-03","2019-12-03","2021-02-24","2020-12-03","2021-04-21","2020-12-03","2020-12-03","2021-02-24","2018-12-12","2021-04-12","2018-12-17","2019-03-18","2018-12-17","2019-01-30","2019-01-30","2019-03-27","2019-03-27","2021-04-21","2019-03-27","2019-03-27","2021-04-21","2019-03-27","2020-04-02","2018-06-12","2018-06-12","2018-06-12","2018-04-10","2018-06-12","2018-04-20","2018-04-20","2018-05-31","2018-04-20","2018-04-20","2020-05-29","2018-04-20","2021-04-21","2018-05-03","2020-05-11","2020-05-09","2020-05-08","2020-05-08","2020-05-10","2020-05-08","2020-05-11","2020-05-29","2020-05-08","2020-05-08","2020-05-08","2020-05-08","2020-05-08","2018-05-09","2018-05-09","2018-05-09","2020-05-09","2018-05-10","2018-05-10","2019-05-13","2018-05-16","2020-05-29","2019-06-12","2018-05-16","2019-06-11","2019-05-21","2020-05-29","2020-05-29","2020-05-29","2020-05-29","2020-07-20","2019-06-11","2019-06-12","2021-04-21","2021-04-21","2021-03-09","2021-03-09","2021-02-24","2021-01-26","2021-01-26","2021-03-19","2021-03-04","2021-04-21","2021-04-29","2021-04-29"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"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":[["","56151014701","TRUPLUS LANC","MIS 33G","","Select","Select",""],["","54429931","FUROSEMIDE","TAB 40MG","","Select","Select",""],["","51672403001","WARFARIN","TAB 3MG","","Select","Select",""],["","60505001406","DILT-XR","CAP 120MG","","Select","Select",""],["","68382013805","TOPIRAMATE","TAB 25MG","","Select","Select",""],["","68682036790","DILTIAZEM","CAP 120MG\/24","","Select","Select",""],["","68180037703","LOSARTAN POT","TAB 50MG","","Select","Select",""],["","169369619","NOVOLOG MIX","INJ FLEXPEN","","Select","Select",""],["","62037099901","POT CL MICRO","TAB 20MEQ ER","","Select","Select",""],["","24586903","TOUJEO SOLO","INJ 300IU\/ML","","Select","Select",""],["","8290320109","BD PEN NEEDL","MIS 31GX8MM","","Select","Select",""],["","591544210","PREDNISONE","TAB 10MG","","Select","Select",""],["","68462024805","RANITIDINE","TAB 150MG","","Select","Select",""],["","16729013401","ALLOPURINOL","TAB 100MG","","Select","Select",""],["","527131301","PILOCARPINE","TAB 5MG","","Select","Select",""],["","172572960","FAMOTIDINE","TAB 40MG","","Select","Select",""],["","363237102","LANCETS MICR","MIS THIN 33G","","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","","Select","Select",""],["","53489032801","SPIRONOLACT","TAB 50MG","","Select","Select",""],["","115164501","NITROFUR MAC","CAP 100MG","","Select","Select",""],["","63304007601","POT CHLORIDE","TAB 10MEQ ER","","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","","Select","Select",""],["","68382050010","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","","Select","Select",""],["","61314064725","TOBRA\/DEXAME","SUS 0.3-0.1%","","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","","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":[[["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["No","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":""}]}]}