{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATTY B NIBLETT","gend":1,"add":"116 S BEAVER ST","city":"MARTINSVILLE","state":"VA","zip":"24112-9998","dob":"1953-12-02","age":"","mstatus":"","insh":11007122,"cliId":"5GM7PR9EG33","pno":2766326441,"cno":2766326441,"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":"116 S BEAVER 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":["F33.1","M79.7","M17.0","Z79.899","M62.830","M19.012","M75.52","M47.816","M12.88","E66.01","I10","E11.42","E11.8","M54.5","M25.561","G89.29","M25.562","Z79.891","G47.33","L25.9","G89.4","M25.569","E78.5","E55.9","J45.20","Z12.31","K59.00","K57.90","R10.30","E11.9","K21.9","Z90.710","Z90.49","Z98.890","R10.31","R10.12","K57.32","J44.9","F33.9","E11.51","F41.9","M25.50","M81.0","Z79.1","Z80.9","Z81.1","Z81.8","Z82.3","Z82.49","M17.10","B35.4","Z23","F33.3","M25.511","M25.512","T14.90XA","M25.551","S09.90XA","R07.81","Z04.3","S49.92XA","S49.91XA","S89.91XA","W17.89XA","Y92.9","M79.661","F32.9","F31.4","Z03.818","Z11.59","M71.9","M17.11","M17.12","R43.0","Z20.828","H52.4","Z99.89","Z97.3","J30.2","R13.10","K57.92","K50.90","F41.1","N39.3","M19.90","R60.9","Z68.41","M19.019","Z20.822","J01.90","R05"],"date":["2021-11-23","2021-10-14","2021-10-14","2021-10-14","2020-01-28","2020-04-09","2020-01-28","2020-01-28","2020-01-28","2020-09-27","2021-10-07","2021-10-07","2020-02-04","2021-09-16","2020-09-24","2020-02-04","2020-02-04","2020-11-18","2021-10-07","2019-04-29","2021-10-14","2021-10-14","2021-10-07","2021-01-04","2020-09-27","2021-08-03","2020-06-22","2020-06-22","2020-06-22","2020-06-22","2020-09-27","2020-09-24","2020-09-24","2020-06-22","2020-06-22","2020-06-22","2020-06-22","2020-09-27","2019-08-21","2019-08-21","2019-08-21","2019-08-21","2019-08-21","2020-09-24","2019-08-21","2019-08-21","2019-08-21","2019-08-21","2019-08-21","2021-10-14","2020-09-01","2021-10-07","2021-09-02","2020-09-24","2020-09-24","2020-09-24","2020-09-24","2020-09-24","2020-09-24","2020-09-24","2020-09-24","2020-09-24","2020-09-24","2020-09-24","2020-09-24","2020-09-24","2019-10-03","2020-11-09","2020-11-19","2020-11-19","2021-01-28","2021-10-14","2021-10-14","2020-11-18","2020-11-18","2020-09-27","2020-09-27","2020-09-27","2020-09-27","2020-09-27","2020-09-27","2020-09-27","2020-09-27","2020-09-27","2020-09-27","2020-09-27","2020-09-27","2021-10-14","2021-09-04","2021-09-04","2021-09-04"],"priorHcc":[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":[["","47781026405","OXYCODONE","TAB 15MG","","Select","Select",""],["","54327099","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","59762372104","ALPRAZOLAM","TAB 1MG","","Select","Select",""],["","93736710","LOSARTAN\/HCT","TAB 50-12.5","","Select","Select",""],["","55111015901","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","378262501","AMITRIPTYLIN","TAB 25MG","","Select","Select",""],["","55111028050","LEVOFLOXACIN","TAB 500MG","","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","603465502","MONTELUKAST","TAB 10MG","","Select","Select",""],["","93317431","ALBUTEROL SUL","FAT E","","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","","Select","Select",""],["","168005415","NYSTATIN","CRE 100000","","Select","Select",""],["","378075101","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","16571041250","CIPROFLOXACN","TAB 500MG","","Select","Select",""],["","172541146","FLUCONAZOLE","TAB 100MG","","Select","Select",""],["","50111078766","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","69547035302","NARCAN","SPR ","","Select","Select",""],["","904655161","ONDANSETRON","TAB 4MG","","Select","Select",""],["","47781026405","OXYCODONE ","TAB 15MG","120","Select","Select",""],["","55111015901","OMEPRAZOLE ","CAP 40MG","90","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","Select","Select",""],["","93736710","LOSARTAN\/HCT ","TAB 50-12.5","60","Select","Select",""],["","54327099","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","59762372104","ALPRAZOLAM ","TAB 1MG","90","Select","Select",""],["","378262501","AMITRIPTYLIN ","TAB 25MG","30","Select","Select",""],["","13668008190","MONTELUKAST ","TAB 10MG","90","Select","Select",""],["","55111028050","LEVOFLOXACIN ","TAB 500MG","10","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","93317431","ALBUTEROL ","FAT E","8.5","Select","Select",""],["","16571041250","CIPROFLOXACN ","TAB 500MG","20","Select","Select",""],["","50111033401","METRONIDAZOL ","TAB 500MG","30","Select","Select",""],["","904655161","ONDANSETRON ","TAB 4MG","15","Select","Select",""],["","50111078766","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","65162019050","NAPROXEN ","TAB 500MG","30","Select","Select",""],["","378075101","CYCLOBENZAPR ","TAB 10MG","30","Select","Select",""],["","172541146","FLUCONAZOLE ","100MG","10","Select","Select",""],["","168005415","NYSTATIN ","100000","30","Select","Select",""],["","59310057922","PROAIR","","8.5","Select","Select",""],["","00093317431","ALBUTEROL","E","8.5","Select","Select",""],["","00143980305","DOXYCYCL","100MG","20","Select","Select",""],["","55111019905","SIMVASTATIN","20MG","90","Select","Select",""],["","00143980305","DOXYCYCL ","CAP 100MG","20","Select","Select",""],["","55111019905","SIMVASTATIN ","TAB 20MG","90","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":""}]}]}