{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LARRY W HOLMES","gend":0,"add":"1090 THREE  GEN DR","city":"BEDFORD  ","state":"VA","zip":"24523-9998","dob":"1957-03-05","age":"","mstatus":"","insh":11005338,"cliId":"4CE7MW4KC43","pno":5408757500,"cno":5408757500,"email":"","ename":"","eno":"","pphy":"BOLUSA-SABUGO, AHGNES U ","ppno":4349475967,"pcpadd":"320 Federal St","pcpcity":"Lynchburg","pcpstate":"VA","pcpzip":245042306,"pcpcounty":"","pcpid":"P9058759","pcpname":"JOHNSON HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1090 THREE  GEN DR","madd2":"","madd3":"","mcity":"BEDFORD  ","mstate":"VA","mzip":"24523-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["M51.37","M96.1","M47.12","G89.4","M54.5","M62.830","M79.604","M79.605","I70.323","M54.2","Z79.899","R09.02","J44.9","Z79.891","E11.9","R21","E66.3","R60.9","Z91.19","M54.17","I10","E05.90","E78.5","Z00.01","K21.9","Z95.828","Z12.5","J43.9","H52.4","G47.33","Z72.0","S91.115A","F17.210","W27.2XXA","Z79.01","Z79.84","Z95.1","Z23","M54.16","E13.40","T14.8XXA","L03.90","S50.812A","I25.10","W54.8XXA","Z79.02","I87.2","J18.9","J44.0","R06.02","M79.89","Z87.891","R91.8","R05","I51.7","G89.29","B86","M20.42","N40.1","I11.0","I50.23","J96.11","I27.20","E11.51","Z99.81","I48.0","I25.5","J81.0","R60.0","R06.89","Z09","Z87.01","S09.90XA","S19.9XXA","M47.812","M41.9","M48.02","S49.92XA","M19.012","S39.92XA","M85.80","S29.9XXA","J13","N17.9","I12.9","E11.22","N18.3","I73.9","R42","J96.22","J96.21","I13.0","I50.20","J44.1","E86.0","R50.9","R06.00","R06.81","I71.4","S81.802A","G47.34","K43.6","E66.9","M53.3","N18.30","M47.816","S39.93XA","N28.1","K42.9","S46.812A","V43.52XA","S16.1XXA","R51.9","M25.512","F41.9","K41.90","K43.0","G89.18","I50.89","Z20.822","I21.A1","R65.10","E87.0","E87.1","I50.22","I25.810","J20.9","R06.9","M51.16","Z79.51","I48.91","E66.01","R07.89","R07.9","I21.4","R77.8","E11.65","R63.2","I34.0","R63.1","S51.812A","S51.802A","I50.30","W22.8XXA","Y92.89","S99.922A","F17.200","S92.532A","W23.1XXA","Z12.2"],"date":["2020-12-29","2020-12-29","2020-12-29","2020-03-02","2021-05-12","2019-03-11","2020-07-31","2020-09-23","2019-03-11","2020-12-01","2021-09-02","2021-08-09","2021-09-21","2021-09-20","2021-09-21","2019-11-11","2019-09-23","2019-03-22","2019-03-22","2020-11-03","2021-11-10","2020-11-10","2021-07-07","2020-04-13","2020-11-10","2020-11-10","2020-04-13","2020-04-14","2019-06-26","2021-08-09","2021-07-07","2019-08-16","2021-08-09","2019-08-16","2021-05-27","2021-02-26","2021-02-26","2021-08-07","2020-09-29","2020-09-29","2019-10-03","2019-10-03","2019-10-06","2021-08-07","2019-10-06","2019-10-06","2019-10-23","2019-12-12","2021-05-23","2021-05-23","2019-10-23","2021-11-18","2019-11-15","2019-10-23","2020-12-01","2021-02-26","2020-11-10","2020-11-10","2020-11-10","2019-11-15","2019-11-25","2019-11-15","2019-11-15","2021-05-23","2020-12-01","2021-07-07","2019-12-19","2019-11-15","2019-11-25","2019-11-15","2019-11-25","2019-11-25","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2019-12-12","2021-05-23","2019-12-12","2021-08-07","2019-12-13","2021-07-07","2019-12-12","2019-12-13","2021-05-27","2021-08-07","2021-05-23","2021-05-27","2019-12-12","2019-12-12","2019-12-13","2019-12-13","2021-07-07","2018-12-21","2021-04-30","2021-04-02","2021-04-08","2021-05-12","2021-08-07","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2021-05-19","2021-03-04","2021-03-04","2021-03-04","2021-02-26","2021-05-23","2021-05-24","2021-05-27","2021-05-23","2021-05-23","2021-05-23","2021-05-23","2021-05-23","2021-05-26","2021-05-19","2021-05-23","2021-06-29","2021-05-24","2021-05-23","2021-05-25","2021-05-24","2021-05-25","2021-06-09","2021-06-09","2021-07-07","2021-07-08","2021-08-07","2021-08-07","2021-08-07","2021-08-07","2021-08-07","2021-07-16","2021-08-09","2021-07-16","2021-07-16","2021-11-18"],"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":[["","10702005601","OXYCODONE","TAB 10MG","","Select","Select",""],["","378021610","FUROSEMIDE","TAB 40MG","","Select","Select",""],["","16714008210","HYDROXYZ HCL","TAB 25MG","","Select","Select",""],["","3089421","ELIQUIS","TAB 5MG","","Select","Select",""],["","173069700","ADVAIR DISKU","AER 500\/50","","Select","Select",""],["","68382076010","METFORMIN","TAB 1000MG","","Select","Select",""],["","57237001401","TAMSULOSIN","CAP 0.4MG","","Select","Select",""],["","597002402","COMBIVENT","AER 20-100","","Select","Select",""],["","597015330","JARDIANCE","TAB 25MG","","Select","Select",""],["","57664016758","METOPROL TAR","TAB 100MG","","Select","Select",""],["","65862052305","GABAPENTIN","TAB 600MG","","Select","Select",""],["","70377003012","ATORVASTATIN","TAB 80MG","","Select","Select",""],["","24208029505","TOBRA\/DEXAME","SUS 0.3-0.1%","","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","","Select","Select",""],["","65862020390","LOSARTAN POT","TAB 100MG","","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","472024260","PERMETHRIN","CRE 0.05","","Select","Select",""],["","69547035302","NARCAN","SPR ","","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","","Select","Select",""],["","591565810","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","59746028390","PANTOPRAZOLE","TAB 20MG","","Select","Select",""],["","93317431","ALBUTEROL SUL","FAT E","","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","","Select","Select",""],["","185067401","HYDROXYZ PAM","CAP 25MG","","Select","Select",""],["","59762330403","NITROGLYCERN","SUB 0.4MG","","Select","Select",""],["","23155017801","ISOSORB MONO","TAB 60MG ER","","Select","Select",""],["","781185220","AMOX\/K CLAV","TAB 875-125","","Select","Select",""],["","31722093612","OMEGA-3-ACID","CAP 1GM","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","310621030","FARXIGA","TAB 10MG","","Select","Select",""],["","68462079817","TRIAMCINOLON","OIN 0.005","","Select","Select",""],["","49281042050","FLUZONE QUAD","INJ 2020-21","","Select","Select",""],["","68382076010","METFORMIN ","TAB 1000MG","180","Select","Select",""],["","378021610","FUROSEMIDE ","TAB 40MG","90","Select","Select",""],["","57237001401","TAMSULOSIN ","CAP 0.4MG","90","Select","Select",""],["","185067401","HYDROXYZ ","CAP 25MG","120","Select","Select",""],["","10702005601","OXYCODONE ","TAB 10MG","150","Select","Select",""],["","3089421","ELIQUIS ","TAB 5MG","60","Select","Select",""],["","173069700","ADVAIR ","AER 500\/50","180","Select","Select",""],["","59310057922","PROAIR ","AER ","51","Select","Select",""],["","57664016758","METOPROL ","TAB 100MG","60","Select","Select",""],["","24208029505","TOBRA\/DEXAME ","SUS 0.3-0.1%","5","Select","Select",""],["","591565810","CYCLOBENZAPR ","TAB 10MG","90","Select","Select",""],["","70377003012","ATORVASTATIN ","TAB 80MG","90","Select","Select",""],["","597002402","COMBIVENT ","AER 20-100","12","Select","Select",""],["","65862052305","GABAPENTIN ","TAB 600MG","270","Select","Select",""],["","597015330","JARDIANCE ","TAB 25MG","90","Select","Select",""],["","55111019690","CLOPIDOGREL ","TAB 75MG","90","Select","Select",""],["","68180071160","CEFDINIR ","CAP 300MG","12","Select","Select",""],["","68180016006","AZITHROMYCIN ","TAB 250MG","2","Select","Select",""],["","62175061846","PANTOPRAZOLE ","TAB 20MG","90","Select","Select",""],["","93317431","ALBUTEROL ","FAT E","25.5","Select","Select",""],["","68180072103","AMLODIPINE ","TAB 10MG","90","Select","Select",""],["","65862020390","LOSARTAN ","TAB 100MG","90","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","68180012202","CEPHALEXIN ","CAP 500MG","12","Select","Select",""],["","53746010901","HYDROCO\/APAP ","TAB 5-325MG","30","Select","Select",""],["","472024260","PERMETHRIN ","CRE 0.05","60","Select","Select",""],["","49281042050","FLUZONE ","INJ 2020-21","0.5","Select","Select",""],["","59762330403","NITROGLYCERN ","SUB 0.4MG","25","Select","Select",""],["","23155017801","ISOSORB ","TAB 60MG ER","90","Select","Select",""],["","93540189","OMEGA-3-ACID ","CAP 1GM","360","Select","Select",""],["","781185220","AMOX\/K ","TAB 875-125","20","Select","Select",""],["","310621030","FARXIGA ","TAB 10MG","90","Select","Select",""],["","8290320122","BD  PEN NEEDL","32GX4MM","100","Select","Select",""],["","53885027210","ONETOUCH ","VERIO","100","Select","Select",""],["","88221905","LANTUS ","100\/ML","15","Select","Select",""],["","68462079817","TRIAMCINOLON ","0.50%","15","Select","Select",""],["","378064205","PREDNISONE ","20MG","5","Select","Select",""],["","50742024990","DILTIAZEM ","180MG ER","30","Select","Select",""],["","16714008210","HYDROXYZ","25MG","120","Select","Select",""],["","00173069700","ADVAIR","500\/50","180","Select","Select",""],["","59310057922","PROAIR","","51","Select","Select",""],["","00088221905","LANTUS","100\/ML","15","Select","Select",""],["","57664016758","METOPROL","100MG","60","Select","Select",""],["","65862020390","LOSARTAN","100MG","90","Select","Select",""],["","08290320122","BD PEN NEEDL","32GX4MM","100","Select","Select",""],["","00093317431","ALBUTEROL","E","25.5","Select","Select",""],["","49281042050","FLUZONE","2020-21","0.5","Select","Select",""],["","53885027210","ONETOUCH","VERIO","100","Select","Select",""],["","23155017801","ISOSORB","60MG ER","90","Select","Select",""],["","50742024990","DILTIAZEM","180MG ER","90","Select","Select",""],["","00781185220","AMOX\/K","875-125","20","Select","Select",""],["","00378064205","PREDNISONE","20MG","5","Select","Select",""],["","53489011905","DOXYCYCL","100MG","14","Select","Select",""],["","00254302902","LUBIPROSTONE ","CAP 24MCG","60","Select","Select",""],["","53489011905","DOXYCYCL ","CAP 100MG","14","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","",""],["Yes","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":""}]}]}