{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ABIGAIL J WALKER","gend":1,"add":"3808 MELROSE AVE NW","city":"ROANOKE","state":"VA","zip":240179999,"dob":"1958-06-07","age":"","mstatus":"","insh":11007471,"cliId":"7F86QE2GW54","pno":5407592245,"cno":5407950513,"email":"","ename":"","eno":"","pphy":"DELANEY, RUSSELL E","ppno":5407723433,"pcpadd":"1802 Braeburn Dr","pcpcity":"Salem","pcpstate":"VA","pcpzip":241537357,"pcpcounty":"","pcpid":"P0123923","pcpname":"LEWIS GALE PHYSICIANS LLC","plan":"VPHP - VIRGINIA PREMIER","program":"Medicare","lob":"DSNP","region":"ROANOKE\/ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F33.1","M51.36","M19.90","G89.4","Z02.89","R29.6","R60.0","T14.8XXA","M15.9","G89.29","I69.30","I25.2","E11.40","J44.9","E66.01","F17.200","M47.812","Z79.899","I87.2","F41.8","R68.89","Z86.59","Z76.0","Z86.73","Z74.09","E11.9","I10","M25.569","R20.0","M79.89","R79.89","M17.12","Z68.41","Z72.0","F17.210","E11.8","M17.10","G62.9","R09.89","Z12.39","S90.422S","L03.90","I83.93","M54.12","M79.7","R10.9","M54.9","Z79.51","Z79.891","G47.9","M25.562","Z09","R51","J30.89","J34.3","L03.031","L97.511","E11.41","M79.674","M79.675","R26.2","M17.9","M25.552","R11.2","R19.7","Z90.49","R52","Z74.3","M54.5","M25.572","F32.9","M79.10","Z86.79","R60.9"],"date":["2020-10-05","2021-04-09","2020-01-24","2021-04-09","2020-02-05","2021-01-19","2020-02-05","2020-02-05","2020-02-05","2020-09-12","2020-03-12","2020-02-05","2021-04-09","2020-07-01","2020-03-12","2020-09-12","2021-04-09","2021-04-09","2021-04-20","2020-03-12","2020-03-12","2020-03-12","2020-03-12","2021-01-19","2021-01-19","2020-09-12","2021-04-20","2019-06-04","2019-06-04","2019-07-02","2019-07-02","2019-07-24","2020-07-28","2021-04-20","2020-07-01","2021-04-20","2021-04-20","2020-07-01","2020-07-01","2020-07-01","2019-07-02","2019-07-02","2019-07-02","2019-12-18","2019-07-12","2020-09-12","2019-07-14","2020-09-12","2021-04-09","2019-07-25","2019-07-25","2019-07-25","2020-08-21","2020-07-28","2020-07-28","2019-08-06","2019-08-06","2019-08-06","2019-08-06","2019-08-06","2019-08-06","2019-10-18","2020-08-21","2020-08-21","2020-08-21","2020-08-21","2020-08-21","2020-09-12","2020-09-12","2019-09-27","2021-01-20","2020-10-05","2021-01-20","2021-01-20"],"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":[["","65862052305","GABAPENTIN","TAB 600MG","","Select","Select",""],["","68382014014","TOPIRAMATE","TAB 100MG","","Select","Select",""],["","31722053201","TORSEMIDE","TAB 100MG","","Select","Select",""],["","68382003416","VENLAFAXINE","CAP 37.5 ER","","Select","Select",""],["","52817018210","CLONIDINE","TAB 0.3MG","","Select","Select",""],["","169406012","VICTOZA","INJ 18MG\/3ML","","Select","Select",""],["","51672131200","MUPIROCIN","OIN 0.02","","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","","Select","Select",""],["","59651017401","DOXEPIN HCL","CAP 25MG","","Select","Select",""],["","71101768","LYRICA","CAP 200MG","","Select","Select",""],["","67877011601","METHADONE","TAB 10MG","","Select","Select",""],["","68180072003","AMLODIPINE","TAB 5MG","","Select","Select",""],["","193725201","CONTOUR","KIT NEXT EZ","","Select","Select",""],["","62332004690","VALSARTAN","TAB 160MG","","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","","Select","Select",""],["","16729013716","CLONAZEPAM","TAB 1MG","","Select","Select",""],["","8496331001","KROGER LANCE","MIS 33G","","Select","Select",""],["","8214055080","PEN NEEDLES","MIS 31GX3\/16","","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","","Select","Select",""],["","67877046990","PREGABALIN","CAP 300MG","","Select","Select",""],["","68180012101","CEPHALEXIN","CAP 250MG","","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","","Select","Select",""],["","24208039915","IPRATROPIUM","SPR 0.0006","","Select","Select",""],["","69315011610","FUROSEMIDE","TAB 20MG","","Select","Select",""],["","60505014202","GLIPIZIDE","TAB 10MG","","Select","Select",""],["","8290326895","BD SWAB REG","PAD SNGL USE","","Select","Select",""],["","68382032001","POT CHLORIDE","TAB 10MEQ ER","","Select","Select",""],["","38396030318","LANCET ULTRA","MIS THIN 30G","","Select","Select",""],["","54327099","FLUTICASONE","SPR 50MCG","","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":[[["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["No","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":""}]}]}