{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARCIANNA M PHELPS","gend":1,"add":"219 BROAD ST","city":"MARTINSVILLE","state":"VA","zip":"24112-9998","dob":"1951-01-12","age":"","mstatus":"","insh":11006964,"cliId":"3RP3PF6GX08","pno":2766965242,"cno":"","email":"","ename":"","eno":"","pphy":"AARON, CAREN T ","ppno":2766660452,"pcpadd":"319 Hospital Dr Ste 101","pcpcity":"Martinsville","pcpstate":"VA","pcpzip":241121928,"pcpcounty":"","pcpid":"P9058808","pcpname":"MARTINSVILLE PHYSICIAN PRACTICES LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"219 BROAD ST","madd2":"","madd3":"","mcity":"MARTINSVILLE","mstate":"VA","mzip":"24112-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["N39.0","R39.9","R73.09","S46.911A","E11.9","M25.511","M75.81","M75.41","M62.81","A49.9","M62.838","M50.30","F41.9","I25.10","E78.5","I10","Z95.1","Z79.84","Z87.891","I65.29","Z95.5","Z79.82","I25.9","R07.9","Z82.49","Z79.899","S09.90XA","W19.XXXA","S09.93XA","S29.9XXA","G45.9","R29.818","R79.89","R94.31","E87.6","I34.0","R29.90","R47.01","S06.0X9A","R45.1","R41.0","Z91.81","R77.8","A41.9","D72.829","R41.82","W19.XXXD","S06.0X0A","F80.2","I21.A1","R17","R65.10","E11.65","S00.11XA","E66.3","W18.30XA","Y92.009","I21.4","I63.511","G81.94","R29.701","G47.00","I63.441","R20.2","I51.7","I51.89","I63.9","R53.1","R73.9","I69.354","I50.30","G43.909","R26.9"],"date":["2021-06-24","2020-02-03","2020-02-03","2020-02-03","2021-07-09","2020-04-29","2020-04-29","2020-04-29","2021-09-02","2019-04-25","2020-04-29","2020-04-29","2021-06-24","2021-07-09","2021-07-09","2021-06-24","2021-06-20","2021-06-20","2021-06-20","2021-01-15","2020-12-17","2021-06-20","2021-01-15","2019-09-06","2019-09-06","2021-01-15","2020-12-12","2021-06-20","2020-12-12","2020-12-12","2020-12-14","2021-06-20","2020-12-16","2020-12-13","2020-12-16","2020-12-14","2021-06-21","2021-06-20","2020-12-14","2020-12-14","2020-12-14","2020-12-14","2020-12-18","2020-12-16","2020-12-14","2020-12-12","2020-12-12","2020-12-12","2020-12-12","2020-12-12","2020-12-12","2020-12-12","2021-07-09","2020-12-12","2020-12-12","2020-12-12","2020-12-12","2020-12-18","2021-08-05","2021-07-09","2021-06-20","2021-06-20","2021-06-23","2021-06-23","2021-06-22","2021-06-22","2021-07-09","2021-06-22","2021-07-09","2021-07-09","2021-07-09","2021-06-24","2021-09-02"],"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":[["","68382076010","METFORMIN","TAB 1000MG","","Select","Select",""],["","57664050658","METOPROL TAR","TAB 25MG","","Select","Select",""],["","13107008405","LORAZEPAM","TAB 1MG","","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","","Select","Select",""],["","68382002401","ATENOLOL","TAB 100MG","","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","","Select","Select",""],["","6483703","PNEUMOVAX 23","INJ 25\/0.5","","Select","Select",""],["","69097015807","MELOXICAM","TAB 7.5MG","","Select","Select",""],["","245531911","KLOR-CON M20","TAB 20MEQ ER","","Select","Select",""],["","591578301","ATENOL\/CHLOR","TAB 100-25MG","","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","","Select","Select",""],["","13107008405","LORAZEPAM ","TAB 1MG","90","Select","Select",""],["","68382076010","METFORMIN ","TAB 1000MG","180","Select","Select",""],["","68180072003","AMLODIPINE ","TAB 5MG","90","Select","Select",""],["","57664050658","METOPROL ","TAB 25MG","60","Select","Select",""],["","70377002911","ATORVASTATIN ","TAB 40MG","90","Select","Select",""],["","68382002401","ATENOLOL ","TAB 100MG","90","Select","Select",""],["","6483703","PNEUMOVAX ","INJ 25\/0.5","0.5","Select","Select",""],["","65862042005","SMZ\/TMP ","TAB 800-160","10","Select","Select",""],["","69097015807","MELOXICAM ","TAB 7.5MG","28","Select","Select",""],["","47781030301","NITROFURANTN ","CAP 100MG","14","Select","Select",""],["","591578301","ATENOL\/CHLOR ","TAB 100-25MG","90","Select","Select",""],["","65862035790","CLOPIDOGREL ","75MG","30","Select","Select",""],["","245531911","KLOR-CON ","20MEQ ER","60","Select","Select",""],["","00002143380","TRULICITY ","0.75\/0.5","2","Select","Select",""],["","00597015330","JARDIANCE ","25MG","30","Select","Select",""],["","53885027210","ONETOUCH ","VERIO","100","Select","Select",""],["","68180051303","LISINOPRIL ","5MG","15","Select","Select",""],["","69097052444","DICLOFENAC ","0.01","100","Select","Select",""],["","00002143380","TRULICITY","0.75\/0.5","2","Select","Select",""],["","00597015330","JARDIANCE","25MG","30","Select","Select",""],["","57664050658","METOPROL","25MG","60","Select","Select",""],["","53885044801","ONETOUCH","ULTRA 2","1","Select","Select",""],["","69097052444","DICLOFENAC","0.01","100","Select","Select",""],["","68180051303","LISINOPRIL","5MG","15","Select","Select",""],["","00006483703","PNEUMOVAX","25\/0.5","0.5","Select","Select",""],["","65862042005","SMZ\/TMP","800-160","10","Select","Select",""],["","00245531911","KLOR-CON","20MEQ ER","60","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":""}]}]}