{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHIRLEY K FOSTER","gend":1,"add":"600 E WILLIAMSBURG RD","city":"SANDSTON ","state":"VA","zip":"23150-9998","dob":"1943-11-01","age":"","mstatus":"","insh":11006148,"cliId":"7MV4C34FV81","pno":8043862892,"cno":8043862892,"email":"","ename":"","eno":"","pphy":"PINSON, ANDY G ","ppno":8048288786,"pcpadd":"417 N 11th St","pcpcity":"Richmond ","pcpstate":"VA","pcpzip":232985002,"pcpcounty":"","pcpid":"P0060138","pcpname":"MCV AMBULATORY CARE CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"APT 307  ","add3":"","madd1":"600 E WILLIAMSBURG RD","madd2":"APT 307  ","madd3":"","mcity":"SANDSTON ","mstate":"VA","mzip":"23150-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["R91.1","J98.4","Z01.810","R94.31","C34.31","R91.8","R10.2","R06.83","R42","I10","I25.10","E78.5","I25.2","Z79.84","K21.9","F32.9","M79.7","F17.200","Z88.6","R06.02","C34.91","M79.10","N18.9","F41.9","R73.03","M19.90","J43.9","Z72.0","I12.9","E11.9","C34.90","M81.0","R35.0","R82.81","J44.9","J32.9","J06.9","Z87.891","F17.210","H61.23","G89.29","J43.2","Z12.31","E11.22","I71.4","I71.9","M15.0","N83.201","Z23","M54.9","M79.18","Z85.43","E53.8","F17.290","N39.0","D12.6","D27.0","Z90.711","N83.291","I73.9","I87.2","E78.00","M79.606","F17.201","J18.1","Z85.118","I70.203","I70.92","G47.9","Z71.9","Z68.29","I21.9","Z68.30","M79.604","M79.605","G47.34","E66.3","R60.0","Z79.899","M79.89","I36.1","J94.8","Z12.39","I83.892","T81.72XA"],"date":["2021-09-29","2020-02-05","2020-01-07","2020-01-07","2021-10-15","2020-01-22","2020-01-22","2021-08-03","2020-01-22","2021-09-21","2021-05-21","2020-01-22","2021-05-12","2020-10-16","2021-09-02","2020-06-19","2021-05-12","2021-09-02","2021-05-12","2020-01-30","2020-01-30","2021-09-02","2020-10-16","2019-09-03","2019-06-19","2020-12-08","2019-02-06","2021-09-21","2020-10-16","2021-09-02","2021-09-02","2021-09-02","2020-03-04","2020-03-04","2021-08-03","2019-05-21","2019-05-21","2021-01-08","2021-05-12","2019-06-19","2021-05-12","2021-01-05","2019-09-30","2020-10-16","2021-01-27","2020-12-03","2019-12-11","2021-01-27","2020-12-08","2019-12-11","2021-01-27","2021-01-27","2021-09-02","2021-01-27","2020-12-08","2020-12-08","2021-04-21","2021-04-21","2021-04-21","2021-09-21","2021-09-21","2021-09-21","2021-05-10","2021-05-10","2021-05-11","2021-05-11","2021-05-12","2021-05-12","2021-05-21","2021-05-21","2021-06-08","2021-03-19","2021-05-04","2021-03-19","2021-03-19","2021-08-03","2021-08-03","2021-09-02","2021-09-02","2021-09-21","2021-04-13","2021-09-29","2021-09-29","2021-11-15","2021-11-17"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",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":[["","65862069790","VENLAFAXINE","CAP 150MG ER","","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","53746011001","HYDROCO\/APAP","TAB 10-325MG","","Select","Select",""],["","228202950","ALPRAZOLAM","TAB 0.5MG","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","23155000810","HYDROCHLOROT","TAB 25MG","","Select","Select",""],["","93317431","ALBUTEROL SUL","FAT E","","Select","Select",""],["","70377000812","ROSUVASTATIN","TAB 20MG","","Select","Select",""],["","53746054201","POT CHLORIDE","CAP 10MEQ ER","","Select","Select",""],["","68382002210","ATENOLOL","TAB 25MG","","Select","Select",""],["","68382075810","METFORMIN","TAB 500MG","","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","65162044210","MECLIZINE","TAB 25MG","","Select","Select",""],["","378911293","NITROGLYCER","DIS 0.4MG\/HR","","Select","Select",""],["","69547035302","NARCAN","SPR ","","Select","Select",""],["","54327099","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","64380080307","RANITIDINE","TAB 150MG","","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","","Select","Select",""],["","65862085901","FAMOTIDINE ","TAB 20MG","180","Select","Select",""],["","67253090150","ALPRAZOLAM ","TAB 0.5MG","35","Select","Select",""],["","64380080307","RANITIDINE ","TAB 150MG","180","Select","Select",""],["","55111015810","OMEPRAZOLE ","CAP 20MG","90","Select","Select",""],["","76385012810","METFORMIN ","TAB 500MG ER","90","Select","Select",""],["","43386035801","HYDROCO\/APAP ","TAB 10-325MG","97","Select","Select",""],["","65862069790","VENLAFAXINE ","CAP 150MG ER","90","Select","Select",""],["","93317431","ALBUTEROL ","FAT E","8.5","Select","Select",""],["","23155000810","HYDROCHLOROT ","TAB 25MG","90","Select","Select",""],["","68382002210","ATENOLOL ","TAB 25MG","90","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","Select","Select",""],["","70377000812","ROSUVASTATIN ","TAB 20MG","90","Select","Select",""],["","53746054201","POT  CHLORIDE","CAP 10MEQ ER","270","Select","Select",""],["","65162044210","MECLIZINE ","TAB 25MG","30","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","378911293","NITROGLYCER ","DIS 0.4MG\/HR","30","Select","Select",""],["","69097052444","DICLOFENAC ","GEL 0.01","1,400.00","Select","Select",""],["","60505082901","FLUTICASONE ","SPR 50MCG","48","Select","Select",""],["","65862035790","CLOPIDOGREL ","TAB 75MG","30","Select","Select",""],["","69097081312","GABAPENTIN ","100MG","60","Select","Select",""],["","47781030301","NITROFURANTN ","100MG","10","Select","Select",""],["","68462010530","ONDANSETRON ","4MG","10","Select","Select",""],["","68180012101","CEPHALEXIN ","250MG","20","Select","Select",""],["","00093317431","ALBUTEROL","E","8.5","Select","Select",""],["","59310057922","PROAIR","","8.5","Select","Select",""],["","65862035790","CLOPIDOGREL","75MG","30","Select","Select",""],["","68180012101","CEPHALEXIN","250MG","20","Select","Select",""],["","69097081312","GABAPENTIN","100MG","60","Select","Select",""],["","68462010530","ONDANSETRON","4MG","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":""}]}]}