{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA K BILLIPS","gend":1,"add":"9962 MUDFORK ROAD ","city":"BLUEFIELD","state":"VA","zip":"24605-8521","dob":"1954-04-05","age":"","mstatus":"","insh":11007144,"cliId":"5RD7QD7TJ57","pno":2763221758,"cno":2763221758,"email":"","ename":"","eno":"","pphy":"RAMAKRISHNAN, KATHRIK","ppno":2763250417,"pcpadd":"1761 Park Ave SW","pcpcity":"Norton","pcpstate":"VA","pcpzip":242731608,"pcpcounty":"","pcpid":"P9058931","pcpname":"PARK AVENUE MEDICAL ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"9962 MUDFORK ROAD ","madd2":"","madd3":"","mcity":"BLUEFIELD","mstate":"VA","mzip":"24605-8521","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["J44.9","J44.1","Z95.2","J98.01","R06.02","Z00.00","Z13.89","Z13.31","Z13.6","Z68.29","R06.00","I05.9","R79.1","K62.5","Z79.01","I25.10","I10","E78.5","K44.9","K64.9","F17.200","R13.10","D64.9","E11.9","Z79.899","E78.2","I48.0","R53.83","E03.9","E55.9","D69.9","R19.7","G47.00","I05.0","R60.9","I38","N18.3","R05","I34.2","Z51.81","J45.901","R11.0","R68.83","R09.02","E87.6","B02.9","M62.81","F43.10","I34.1","S70.02XA","S79.919A","W18.39XA","S20.20XA","Z88.8","Z88.2","R07.9","S20.211A","S52.501A","M25.531","W06.XXXA","Y93.84","Y92.003","E53.8","S52.591A","W19.XXXA","I25.118","Z95.4","I50.9","I20.8","S62.91XA","R07.81","C50.919","I67.89","G47.30","I66.9","R51","R03.0","K92.2","Z23","F41.1","M25.642","M24.532","M25.632","K21.9","R63.4","R63.0","R00.2","N18.30","T46.0X1A","R04.0","R68.81","I48.91","R10.13","J20.9","Z85.3","J02.9","R09.81","R63.8","Z20.822","E83.42","Z68.26","R94.31","G47.33","R53.1","I11.0","E61.1","Z99.89","J39.9","Z12.31","R51.9","Z20.828","Z76.0","Z68.27","R68.89"],"date":["2021-08-19","2021-10-01","2021-11-12","2020-04-14","2021-10-01","2020-02-10","2021-06-08","2021-06-08","2020-02-10","2020-02-10","2021-05-06","2020-08-17","2021-07-21","2020-08-24","2021-11-12","2021-11-04","2021-11-04","2020-02-19","2020-03-09","2020-03-09","2021-07-21","2020-03-09","2020-03-11","2020-03-09","2020-03-09","2021-08-19","2021-09-21","2021-09-21","2021-08-19","2021-08-19","2021-11-12","2021-06-08","2021-02-09","2020-05-05","2020-10-15","2020-06-25","2019-05-28","2021-09-21","2020-08-24","2020-09-25","2020-08-24","2021-06-08","2020-06-25","2020-08-17","2021-08-19","2019-07-15","2019-08-07","2019-08-09","2019-08-14","2019-08-16","2019-08-15","2019-08-15","2019-08-15","2019-08-15","2019-08-15","2020-08-24","2019-08-16","2019-10-14","2019-08-21","2019-08-17","2019-08-17","2019-08-17","2021-08-19","2019-08-21","2019-08-18","2020-08-24","2021-11-04","2021-08-19","2021-11-04","2019-08-28","2019-08-28","2020-08-28","2020-08-28","2020-08-28","2020-09-25","2020-09-25","2020-10-01","2019-12-18","2021-11-12","2019-10-04","2019-10-14","2019-10-14","2019-10-14","2021-08-19","2020-10-15","2020-10-15","2021-06-24","2020-10-22","2020-10-22","2019-10-23","2019-11-12","2021-08-19","2019-12-31","2021-02-12","2021-02-12","2021-02-12","2021-02-12","2021-02-12","2021-02-12","2021-08-19","2021-05-06","2021-11-04","2021-08-19","2021-08-19","2021-08-19","2021-08-19","2021-08-19","2021-08-19","2021-09-10","2021-09-21","2021-09-21","2021-11-12","2021-11-04","2021-02-12"],"priorHcc":["","",null,"","","","","","","","","","","",null,null,null,"","","","","","","","","","","","","",null,"","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",null,"",null,"","","","","","","","","",null,"","","","","","","","","","","","","","","","","","","","","","",null,"","","","","","","","","",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":[["","57237012001","WARFARIN","TAB 2MG","","Select","Select",""],["","49502060561","PERFOROMIST","NEB 20MCG","","Select","Select",""],["","597007541","SPIRIVA","CAP HANDIHLR","","Select","Select",""],["","68645019059","METOPROL TAR","TAB 50MG","","Select","Select",""],["","832532511","POT CL MICRO","TAB 20MEQ ER","","Select","Select",""],["","68645014059","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","13668000701","ZOLPIDEM","TAB 5MG","","Select","Select",""],["","65862044930","VALACYCLOVIR","TAB 1GM","","Select","Select",""],["","406012301","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","487950125","ALBUTEROL","NEB 0.00083","","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","","Select","Select",""],["","54001829","PREDNISONE","TAB 20MG","","Select","Select",""],["","68382000106","PAROXETINE","TAB 40MG","","Select","Select",""],["","67877019705","AMLODIPINE","TAB 2.5MG","","Select","Select",""],["","781518192","LEVOTHYROXIN","TAB 50MCG","","Select","Select",""],["","69238199101","DIGOXIN","TAB 0.125MG","","Select","Select",""],["","31722059690","FENOFIBRATE","TAB 145MG","","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","","Select","Select",""],["","65162025425","RANITIDINE","TAB 300MG","","Select","Select",""],["","378803093","LANSOPRAZOLE","CAP 30MG DR","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","72305002530","EUTHYROX","TAB 25MCG","","Select","Select",""],["","43598043611","NITROGLYCERN","SUB 0.4MG","","Select","Select",""],["","50111043301","TRAZODONE","TAB 50MG","","Select","Select",""],["","13668010401","ISOSORB MONO","TAB 30MG ER","","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","13107000334","MIRTAZAPINE","TAB 30MG","","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","","Select","Select",""],["","93720110","PRAVASTATIN","TAB 20MG","","Select","Select",""],["","24979002702","DILTIAZEM","CAP 180MG ER","","Select","Select",""],["","64980032430","PROCTOZONE","CRE -HC 2.5%","","Select","Select",""],["","781342868","ENOXAPARIN","INJ 80\/0.8ML","","Select","Select",""],["","45802005536","TRIAMCINOLON","OIN 0.001","","Select","Select",""],["","69238110005","DOXYCYCL HYC","CAP 100MG","","Select","Select",""],["","57237012001","WARFARIN ","TAB 2MG","30","Select","Select",""],["","59746017509","PREDNISONE ","TAB 20MG","10","Select","Select",""],["","68645019059","METOPROL ","TAB 50MG","60","Select","Select",""],["","49502060561","PERFOROMIST ","NEB 20MCG","120","Select","Select",""],["","597007541","SPIRIVA ","CAP HANDIHLR","30","Select","Select",""],["","832532511","POT  CL MICRO","TAB 20MEQ ER","60","Select","Select",""],["","68645051654","AMLODIPINE ","TAB 10MG","90","Select","Select",""],["","68382000106","PAROXETINE ","TAB 40MG","30","Select","Select",""],["","93720110","PRAVASTATIN ","TAB 20MG","90","Select","Select",""],["","781342868","ENOXAPARIN ","INJ 80\/0.8ML","4.8","Select","Select",""],["","69238199101","DIGOXIN ","TAB 0.125MG","30","Select","Select",""],["","68645014059","FAMOTIDINE ","TAB 20MG","60","Select","Select",""],["","487950125","ALBUTEROL ","NEB 0.00083","75","Select","Select",""],["","13668000701","ZOLPIDEM ","TAB 5MG","30","Select","Select",""],["","47781064090","LEVOTHYROXIN ","TAB 25MCG","90","Select","Select",""],["","65862044930","VALACYCLOVIR ","TAB 1GM","21","Select","Select",""],["","45802005536","TRIAMCINOLON ","OIN 0.001","80","Select","Select",""],["","406012301","HYDROCO\/APAP ","TAB 5-325MG","12","Select","Select",""],["","31722072250","LEVOFLOXACIN ","TAB 500MG","7","Select","Select",""],["","43547040111","FUROSEMIDE ","TAB 20MG","90","Select","Select",""],["","68180071160","CEFDINIR ","CAP 300MG","20","Select","Select",""],["","65162025425","RANITIDINE ","TAB 300MG","30","Select","Select",""],["","31722059690","FENOFIBRATE ","TAB 145MG","30","Select","Select",""],["","24979002702","DILTIAZEM ","CAP 180MG ER","90","Select","Select",""],["","378803093","LANSOPRAZOLE ","CAP 30MG DR","30","Select","Select",""],["","72305002530","EUTHYROX ","TAB 25MCG","90","Select","Select",""],["","59310057922","PROAIR ","AER ","17","Select","Select",""],["","50111043301","TRAZODONE ","TAB 50MG","30","Select","Select",""],["","50111078751","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","43598043611","NITROGLYCERN ","SUB 0.4MG","25","Select","Select",""],["","13668010401","ISOSORB ","TAB 30MG ER","30","Select","Select",""],["","69238110005","DOXYCYCL ","CAP 100MG","20","Select","Select",""],["","13107000334","MIRTAZAPINE ","TAB 30MG","90","Select","Select",""],["","68462035701","POT  CHLORIDE","10MEQ ER","60","Select","Select",""],["","64980032430","PROCTOZONE ","-HC 2.5%","30","Select","Select",""],["","68645019059","METOPROL","50MG","60","Select","Select",""],["","68462035705","POT CHLORIDE","10MEQ ER","60","Select","Select",""],["","13668010401","ISOSORB","30MG ER","30","Select","Select",""],["","00093406130","FORMOTEROL","20\/2ML","120","Select","Select",""],["","69238110005","DOXYCYCL","100MG","20","Select","Select",""],["","59310057922","PROAIR","","17","Select","Select",""],["","60505476505","APO-VARENICL","0.5MG","11","Select","Select",""],["","60505476505","APO-VARENICL ","TAB 0.5MG","11","Select","Select",""],["","00093406106","FORMOTEROL ","NEB 20\/2ML","120","Select","Select",""],["","49884015676","VARENICLINE ","TAB 1MG","56","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":""}]}]}