{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOEY L CAMERON","gend":0,"add":"213 SHERATON LANE ","city":"TAZEWELL ","state":"VA","zip":"24651-9998","dob":"1978-05-10","age":"","mstatus":"","insh":11007422,"cliId":"7K60KG6HW32","pno":2768071231,"cno":2762459776,"email":"","ename":"","eno":"","pphy":"PABLO M CARPIO MD ","ppno":2769888103,"pcpadd":"212 S Main St Ste 3","pcpcity":"Danville ","pcpstate":"VA","pcpzip":245412943,"pcpcounty":"","pcpid":"P0124518","pcpname":"PABLO M CARPIO MD","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"213 SHERATON LANE ","madd2":"","madd3":"","mcity":"TAZEWELL ","mstate":"VA","mzip":"24651-9998","pcpfaxno":2769887858,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["I10","E11.9","R21","Z79.84","L25.9","Z20.828","M25.561","E66.01","Z23","Z87.81","Z90.49","Z68.41","J30.2","H65.00","R52","J01.90","J20.9","R06.2"],"date":["2021-09-28","2021-09-28","2019-07-05","2020-05-25","2019-07-05","2020-09-23","2019-09-24","2020-05-25","2019-11-21","2020-05-25","2020-05-25","2020-05-25","2021-03-09","2021-09-28","2021-06-21","2021-06-21","2021-06-28","2021-06-28"],"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",""],["","54327099","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","76385011350","CARVEDILOL","TAB 25MG","","Select","Select",""],["","55111032201","GLIMEPIRIDE","TAB 4MG","","Select","Select",""],["","603533815","PREDNISONE","PAK 10MG","","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","","Select","Select",""],["","310620530","FARXIGA","TAB 5MG","","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","","Select","Select",""],["","45802026937","PERMETHRIN","CRE 0.05","","Select","Select",""],["","76385011350","CARVEDILOL ","TAB 25MG","180","Select","Select",""],["","54327099","FLUTICASONE ","SPR 50MCG","48","Select","Select",""],["","68382076010","METFORMIN ","TAB 1000MG","60","Select","Select",""],["","67877032105","IBUPROFEN ","TAB 800MG","90","Select","Select",""],["","603533815","PREDNISONE ","PAK 10MG","21","Select","Select",""],["","55111032201","GLIMEPIRIDE ","TAB 4MG","30","Select","Select",""],["","310620530","FARXIGA ","TAB 5MG","30","Select","Select",""],["","59746000103","METHYLPRED ","TAB 4MG","21","Select","Select",""],["","45802026937","PERMETHRIN ","5%","60","Select","Select",""],["","00093310905","AMOXICILLIN ","500MG","21","Select","Select",""],["","68180016013","AZITHROMYCIN ","250MG","6","Select","Select",""],["","68180016013","AZITHROMYCIN","250MG","6","Select","Select",""],["","00093310905","AMOXICILLIN","500MG","21","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":""}]}]}