{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA S STACY","gend":1,"add":"12026 HURLEY ROAD ","city":"HURLEY","state":"VA","zip":"24620-9998","dob":"1952-02-17","age":"","mstatus":"","insh":11007044,"cliId":"6RN7F40GY58","pno":2762002635,"cno":2762002635,"email":"","ename":"","eno":"","pphy":"COPLEY, CHRISTOPHER  ","ppno":2769351760,"pcpadd":"8243 RIVERSIDE DR","pcpcity":"OAKWOOD  ","pcpstate":"VA","pcpzip":246318973,"pcpcounty":"","pcpid":"P0130311","pcpname":"COMMONWEALTH FAMILY CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"12026 HURLEY ROAD ","madd2":"","madd3":"","mcity":"HURLEY","mstate":"VA","mzip":"24620-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["I10","J44.0","R06.2","R09.89","R50.81","J44.9","R07.1","F11.20","E11.9","R06.02","R06.09","K21.9","R60.0","R73.09","N39.0","R35.0","R39.15","R39.11","R30.0","K59.04","Z79.899","R10.2","M54.5","F17.210","M25.552","E78.5","J44.1","E03.8","E78.01","K59.00","R10.84","Z86.19","N35.92","M25.561","M25.461","R79.89","R53.83","E03.9","M25.50","R53.81","R35.1","N39.3","R10.30","R25.2","F33.1","F41.1","Z87.891","N32.81","Z90.710","M19.90","Z88.5","Z88.8","Z79.84","Z20.828","Z01.812","R11.0","J40","J15.7","R05","R09.82","S52.331A","W01.0XXA","M25.531","S52.501A","S52.501D","S52.591A","M79.631","M54.6","Z87.81","U07.1","R05.9","R91.8"],"date":["2021-10-08","2020-01-03","2020-01-03","2020-01-03","2020-01-03","2021-08-12","2020-01-03","2021-11-03","2021-08-12","2021-05-20","2020-02-20","2021-08-12","2020-02-20","2021-05-20","2020-03-18","2021-06-17","2021-06-17","2021-06-17","2021-06-17","2020-06-30","2021-05-20","2021-06-17","2021-08-24","2021-10-08","2019-07-31","2021-05-20","2020-09-17","2020-09-17","2020-09-17","2020-09-23","2020-09-23","2020-09-23","2020-10-27","2020-10-02","2020-10-02","2020-10-02","2021-05-20","2020-10-27","2020-10-02","2020-10-02","2020-10-27","2020-10-02","2020-12-10","2020-12-10","2021-08-12","2021-08-12","2019-10-22","2020-10-27","2020-10-27","2020-10-27","2020-10-27","2020-10-27","2020-10-27","2020-11-28","2020-11-28","2019-12-02","2021-10-08","2019-12-02","2019-12-02","2019-12-02","2021-02-24","2021-02-24","2021-08-24","2021-05-17","2021-05-17","2021-05-17","2021-05-20","2021-08-24","2021-08-24","2021-10-08","2021-10-08","2021-10-08"],"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":[["","456120130","LINZESS","CAP 145MCG","","Select","Select",""],["","16729000417","SIMVASTATIN","TAB 10MG","","Select","Select",""],["","93317431","ALBUTEROL SUL","FAT E","","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","","Select","Select",""],["","378180010","LEVOTHYROXIN","TAB 25MCG","","Select","Select",""],["","27241015508","OXYBUTYNIN","TAB 5MG ER","","Select","Select",""],["","54018913","BUPREN\/NALOX","SUB 8-2MG","","Select","Select",""],["","57237016199","OMEPRAZOLE","CAP 20MG","","Select","Select",""],["","54001829","PREDNISONE","TAB 20MG","","Select","Select",""],["","65162027210","SMZ\/TMP DS","TAB 800-160","","Select","Select",""],["","781196260","CLARITHROMYC","TAB 500MG","","Select","Select",""],["","57237000205","HYDROCHLOROT","CAP 12.5MG","","Select","Select",""],["","832532310","POT CHLORIDE","TAB 10MEQ ER","","Select","Select",""],["","53885059501","ONETOUCH","MIS 30G","","Select","Select",""],["","781808926","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","310737220","BUDES\/FORMOT","AER 80-4.5","","Select","Select",""],["","64380074108","BUSPIRONE","TAB 5MG","","Select","Select",""],["","173069600","ADVAIR DISKU","AER 250\/50","","Select","Select",""],["","67877016930","ONDANSETRON","TAB 4MG","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","43386005019","GAVILYTE-N","SOL FLAV PK","","Select","Select",""],["","23155010210","METFORMIN","TAB 500MG","","Select","Select",""],["","68180035106","SERTRALINE","TAB 25MG","","Select","Select",""],["","51672128902","NYSTATIN","CRE 100000","","Select","Select",""],["","781261305","AMOXICILLIN","CAP 500MG","","Select","Select",""],["","57664050318","TIZANIDINE","TAB 4MG","","Select","Select",""],["","69547035302","NARCAN","SPR ","","Select","Select",""],["","68462010340","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","55111028050","LEVOFLOXACIN","TAB 500MG","","Select","Select",""],["","378342201","NITROFURANTN","CAP 100MG","","Select","Select",""],["","168000215","TRIAMCINOLON","CRE 0.005","","Select","Select",""],["","54018913","BUPREN\/NALOX ","SUB 8-2MG","28","Select","Select",""],["","16729000417","SIMVASTATIN ","TAB 10MG","30","Select","Select",""],["","456120130","LINZESS ","CAP 145MCG","30","Select","Select",""],["","57237016199","OMEPRAZOLE ","CAP 20MG","30","Select","Select",""],["","68180098103","LISINOPRIL ","TAB 20MG","30","Select","Select",""],["","93317431","ALBUTEROL ","FAT E","17","Select","Select",""],["","378180010","LEVOTHYROXIN ","TAB 25MCG","30","Select","Select",""],["","27241015508","OXYBUTYNIN ","TAB 5MG ER","30","Select","Select",""],["","54001829","PREDNISONE ","TAB 20MG","10","Select","Select",""],["","310737220","BUDES\/FORMOT ","AER 80-4.5","10.2","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","65162027210","SMZ\/TMP ","TAB 800-160","20","Select","Select",""],["","51672128902","NYSTATIN ","CRE 100000","30","Select","Select",""],["","68462010340","FLUCONAZOLE ","TAB 150MG","1","Select","Select",""],["","57237000205","HYDROCHLOROT ","CAP 12.5MG","30","Select","Select",""],["","781261305","AMOXICILLIN ","CAP 500MG","56","Select","Select",""],["","781196260","CLARITHROMYC ","TAB 500MG","28","Select","Select",""],["","832532310","POT  CHLORIDE","TAB 10MEQ ER","4","Select","Select",""],["","67877016930","ONDANSETRON ","TAB 4MG","30","Select","Select",""],["","23155010210","METFORMIN ","TAB 500MG","30","Select","Select",""],["","53885024450","ONETOUCH ","TES ULTRA BL","100","Select","Select",""],["","781808926","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","378342201","NITROFURANTN ","CAP 100MG","20","Select","Select",""],["","55111028050","LEVOFLOXACIN ","TAB 500MG","10","Select","Select",""],["","68180035106","SERTRALINE ","TAB 25MG","30","Select","Select",""],["","64380074108","BUSPIRONE ","TAB 5MG","90","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","Select","Select",""],["","43386005019","GAVILYTE-N ","SOL FLAV PK","4,000.00","Select","Select",""],["","173069600","ADVAIR ","AER 250\/50","60","Select","Select",""],["","57664050318","TIZANIDINE ","TAB 4MG","15","Select","Select",""],["","65862056099","PANTOPRAZOLE ","TAB 40MG","60","Select","Select",""],["","23155050001","HYDROXYZ ","TAB 10MG","30","Select","Select",""],["","65162027110","SMZ-TMP ","400-80MG","20","Select","Select",""],["","69097017364","IPRATROPIUM\/ ","ALBUTER","360","Select","Select",""],["","168000215","TRIAMCINOLON ","0.50%","15","Select","Select",""],["","00093317431","ALBUTEROL","E","17","Select","Select",""],["","65162027210","SMZ\/TMP","800-160","20","Select","Select",""],["","59310057922","PROAIR","","8.5","Select","Select",""],["","23155050001","HYDROXYZ","10MG","30","Select","Select",""],["","00173069600","ADVAIR","250\/50","60","Select","Select",""],["","65162027110","SMZ-TMP","400-80MG","20","Select","Select",""],["","69097017364","IPRATROPIUM\/","ALBUTER","360","Select","Select",""],["","67877032005","IBUPROFEN","600MG","30","Select","Select",""],["","67877032005","IBUPROFEN ","TAB 600MG","30","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":""}]}]}