{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARY M MOORE","gend":1,"add":"112  W WEST STREET","city":"KENBRIDGE","state":"VA","zip":"23944-2020","dob":"1936-05-21","age":"","mstatus":"","insh":11004236,"cliId":"5N86R54CD49","pno":4346768042,"cno":4346768042,"email":"","ename":"","eno":"","pphy":"YORK, LISA M","ppno":4346962165,"pcpadd":"200 E 5th St","pcpcity":"CHASE CITY  ","pcpstate":"VA","pcpzip":239241456,"pcpcounty":"","pcpid":"P9058797","pcpname":"LUNENBURG MEDICAL CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"112  W WEST STREET","madd2":"","madd3":"","mcity":"KENBRIDGE","mstate":"VA","mzip":"23944-2020","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["I10","I49.5","Z95.0","N39.46","L22","R39.81","H04.123","H10.45","E11.9","Z96.1","Z45.018","I45.89","I48.91","E11.22","D64.9","E78.2","Z79.899","I25.10","Z87.891","N18.3","Z45.010","N18.5","R30.0","N30.00","I50.9","I08.9","M19.91","N39.0","D50.9","K21.9","K44.9","K31.819","J45.909","E78.5","I13.0","Z88.5","Z88.0","Z88.8","E55.9","E87.2","I47.1","K21.0","K92.2","K59.00","R19.7","M25.549","I12.9","I12.0","N32.81","R13.10","M19.90","E66.9","E86.0","E83.42","N28.9","R29.6","Z82.49","R53.1","R91.8","S09.8XXA","N17.9","B96.20","B95.4","Z09","W19.XXXA","N39.41","R26.9","Z68.35","R26.81","R30.9","R53.83","N18.9","Z68.29","N18.30","Z45.09"],"date":["2021-07-29","2021-09-03","2021-03-15","2021-11-05","2021-11-05","2021-11-05","2021-07-19","2021-07-19","2021-07-19","2021-07-19","2021-09-03","2020-01-29","2020-03-04","2020-03-04","2021-07-29","2020-03-04","2020-09-08","2020-03-09","2021-03-15","2020-09-14","2021-09-03","2019-09-03","2019-09-03","2019-04-26","2020-09-14","2020-09-08","2020-09-08","2020-09-08","2019-12-27","2019-12-27","2019-12-27","2019-07-01","2019-07-01","2019-07-01","2020-09-14","2019-07-01","2019-07-01","2019-07-01","2021-01-28","2021-01-28","2019-12-27","2019-07-22","2019-07-26","2019-07-26","2019-07-26","2019-08-26","2021-03-15","2020-09-08","2020-09-08","2019-09-10","2019-12-27","2018-10-01","2019-11-26","2018-10-03","2018-10-01","2018-10-08","2018-10-01","2019-11-26","2018-10-01","2018-10-01","2018-10-03","2018-10-08","2018-10-08","2018-10-09","2018-10-09","2018-10-26","2019-12-27","2018-10-26","2018-10-31","2019-11-26","2019-11-26","2019-12-12","2019-12-27","2021-07-29","2021-07-22"],"priorHcc":["","","",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":[["","62175027041","OXYBUTYNIN","TAB 5MG ER","","Select","Select",""],["","193658621","MICROLET","MIS LANCETS","","Select","Select",""],["","67877019810","AMLODIPINE","TAB 5MG","","Select","Select",""],["","69315011610","FUROSEMIDE","TAB 20MG","","Select","Select",""],["","68180012102","CEPHALEXIN","CAP 250MG","","Select","Select",""],["","68001033508","LISINOPRIL","TAB 20MG","","Select","Select",""],["","55111012705","CIPROFLOXACN","TAB 500MG","","Select","Select",""],["","193709021","CONTOUR","TES BLD GLUC","","Select","Select",""],["","64380080307","RANITIDINE","TAB 150MG","","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","","Select","Select",""],["","65862056090","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","67877019810","AMLODIPINE ","TAB 5MG","90","Select","Select",""],["","62175027041","OXYBUTYNIN ","TAB 5MG ER","90","Select","Select",""],["","69315011610","FUROSEMIDE ","TAB 20MG","90","Select","Select",""],["","193658621","MICROLET ","MIS LANCETS","100","Select","Select",""],["","378668977","PANTOPRAZOLE ","TAB 40MG","90","Select","Select",""],["","68001033508","LISINOPRIL ","TAB 20MG","90","Select","Select",""],["","68180012102","CEPHALEXIN ","CAP 250MG","35","Select","Select",""],["","64380080307","RANITIDINE ","TAB 150MG","180","Select","Select",""],["","55111012705","CIPROFLOXACN ","TAB 500MG","14","Select","Select",""],["","193709021","CONTOUR ","TES BLD GLUC","100","Select","Select",""],["","59746017509","PREDNISONE ","TAB 20MG","5","Select","Select",""],["","60505082901","FLUTICASONE ","50MCG","16","Select","Select",""],["","58160082311","SHINGRIX","50\/0.5ML","1","Select","Select",""],["","58160082311","SHINGRIX ","INJ 50\/0.5ML","1","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":""}]}]}