{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ANNA L ELAM","gend":1,"add":"1024 ORCHARD AVENUE  ","city":"WINCHESTER  ","state":"VA","zip":"22601-9998","dob":"1934-05-07","age":"","mstatus":"","insh":11008427,"cliId":"3J20P38TJ28","pno":5405222361,"cno":5405222361,"email":"","ename":"","eno":"","pphy":"BYRD, JESSICA  ","ppno":5406782800,"pcpadd":"2913 Valley Ave Ste 200","pcpcity":"Winchester  ","pcpstate":"VA","pcpzip":226012678,"pcpcounty":"","pcpid":"P9058341","pcpname":"APPLE BLOSSOM FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"PO BOX 2014 ","madd2":"","madd3":"","mcity":"WINCHESTER  ","mstate":"VA","mzip":"22604-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["J44.1","R32","N39.490","L22","R39.81","N32.81","R42","N39.0","B96.20","R06.02","M54.2","R30.0","R10.84","R91.8","I10","F03.90","H35.3131","I48.0","R10.9","I48.91","J44.9","E03.9","M25.561","M25.571","M25.551","S22.31XA","H35.3213","H35.3122","H43.813","H43.39","Z96.1","H04.123","E78.5","R79.89","M43.16","M54.9","M85.88","G89.29","M47.814","M47.816","M85.80","W19.XXXS","D64.9","Z23","M54.16","M43.10","M26.621","H92.03","L82.1","L57.0","R13.12","M48.061","M43.17","M51.16","N28.1","J06.9","R10.13","K44.9","H43.393","K80.20","R13.10","R63.3","I20.9","Z00.00","R07.9","N20.0","K57.30","R62.7","G93.41","G62.9","Z20.822","K76.0","H35.30","R29.6","Z90.710","Z79.890","Z79.82","R05","R53.1","E86.0","L27.0","Z88.1","Z09","H91.90","F41.1","Z98.49","Z87.891","Z85.828","Z68.35","G30.9","F02.80","K21.9","F32.9","E66.8","R06.82","M79.671","M79.672","N64.4","B37.9","N64.89","R92.8","Z80.3","N12","R11.2","I50.31","N10","Z68.36","I11.0","E66.9","R11.10","R93.0","R51.9","N28.89","J81.1","R41.82","Z79.84","R40.1","M62.81","Z87.440"],"date":["2021-02-23","2020-05-22","2021-11-16","2021-11-16","2021-11-16","2021-11-16","2020-01-04","2021-06-24","2021-06-24","2021-06-20","2020-08-26","2021-07-23","2020-01-04","2021-06-20","2021-11-30","2021-11-16","2021-11-16","2021-09-08","2020-06-12","2021-06-24","2021-02-10","2021-09-08","2020-06-23","2020-06-23","2020-06-23","2020-06-23","2021-01-12","2021-01-12","2020-07-07","2020-07-07","2020-07-07","2020-07-07","2021-09-08","2021-09-08","2020-09-12","2021-07-23","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2021-05-04","2020-10-06","2020-10-05","2020-10-05","2020-08-26","2020-08-26","2020-08-28","2020-08-28","2019-10-17","2020-09-12","2020-09-12","2020-09-12","2021-06-20","2019-09-13","2020-11-25","2020-09-22","2019-10-01","2020-11-25","2021-06-23","2019-10-17","2020-11-23","2021-05-07","2021-01-20","2021-02-15","2021-02-06","2021-02-06","2021-02-06","2021-02-10","2021-06-20","2021-06-20","2021-02-10","2021-02-06","2021-02-06","2021-02-06","2021-02-06","2021-02-07","2021-02-15","2021-02-06","2021-02-07","2021-02-06","2021-02-15","2020-05-22","2020-05-22","2020-05-22","2020-05-22","2020-05-22","2020-05-22","2020-05-22","2020-05-22","2021-06-24","2020-05-22","2020-05-22","2021-02-07","2021-04-13","2021-04-13","2021-05-07","2021-05-07","2021-06-15","2021-06-15","2021-06-15","2021-06-20","2021-06-20","2021-06-20","2021-06-24","2021-06-20","2021-06-20","2021-06-20","2021-06-22","2021-06-20","2021-06-20","2021-06-20","2021-06-22","2021-06-23","2021-06-24","2021-02-06","2021-02-10","2021-02-10"],"priorHcc":["","",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":[["","43547027509","DONEPEZIL","TAB 5MG","","Select","Select",""],["","68180071909","AMLODIPINE","TAB 2.5MG","","Select","Select",""],["","781185220","AMOX\/K CLAV","TAB 875-125","","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","378021610","FUROSEMIDE","TAB 40MG","","Select","Select",""],["","93414656","LEVALBUTEROL","NEB 0.63MG","","Select","Select",""],["","57664050658","METOPROL TAR","TAB 25MG","","Select","Select",""],["","64764075030","TRINTELLIX","TAB 20MG","","Select","Select",""],["","13668042990","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","65862005390","SIMVASTATIN","TAB 40MG","","Select","Select",""],["","469260230","MYRBETRIQ","TAB 50MG","","Select","Select",""],["","93221001","SUCRALFATE","TAB 1GM","","Select","Select",""],["","64380080307","RANITIDINE","TAB 150MG","","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","","Select","Select",""],["","45802016000","DICLOFENAC","GEL 0.01","","Select","Select",""],["","173071920","FLOVENT HFA","AER 110MCG","","Select","Select",""],["","378180710","LEVOTHYROXIN","TAB 88MCG","","Select","Select",""],["","68308015215","NYSTATIN","POW 100000","","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","","Select","Select",""],["","65862007601","CIPROFLOXACN","TAB 250MG","","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","68180030360","CEFUROXIME","TAB 500MG","","Select","Select",""],["","54001925","PREDNISONE","TAB 50MG","","Select","Select",""],["","93414656","LEVALBUTEROL ","NEB 0.63MG","90","Select","Select",""],["","378180710","LEVOTHYROXIN ","TAB 88MCG","30","Select","Select",""],["","43547027509","DONEPEZIL ","TAB 5MG","90","Select","Select",""],["","69097081312","GABAPENTIN ","CAP 100MG","180","Select","Select",""],["","378021610","FUROSEMIDE ","TAB 40MG","90","Select","Select",""],["","781185220","AMOX\/K ","TAB 875-125","20","Select","Select",""],["","469260230","MYRBETRIQ ","TAB 50MG","90","Select","Select",""],["","59651000305","OMEPRAZOLE ","CAP 40MG","90","Select","Select",""],["","68180071909","AMLODIPINE ","TAB 2.5MG","90","Select","Select",""],["","64764075030","TRINTELLIX ","TAB 20MG","30","Select","Select",""],["","65862005390","SIMVASTATIN ","TAB 40MG","30","Select","Select",""],["","57664050658","METOPROL ","TAB 25MG","180","Select","Select",""],["","13668042990","PANTOPRAZOLE ","TAB 40MG","180","Select","Select",""],["","93221001","SUCRALFATE ","TAB 1GM","120","Select","Select",""],["","51672128901","NYSTATIN ","CRE 100000","15","Select","Select",""],["","47781030301","NITROFURANTN ","CAP 100MG","14","Select","Select",""],["","64380080307","RANITIDINE ","TAB 150MG","60","Select","Select",""],["","173071920","FLOVENT ","AER 110MCG","36","Select","Select",""],["","65862007601","CIPROFLOXACN ","TAB 250MG","6","Select","Select",""],["","45802016000","DICLOFENAC ","GEL 0.01","200","Select","Select",""],["","68180012202","CEPHALEXIN ","CAP 500MG","28","Select","Select",""],["","54001925","PREDNISONE ","TAB 50MG","5","Select","Select",""],["","68180030360","CEFUROXIME ","TAB 500MG","14","Select","Select",""],["","00781185220","AMOX\/K","875-125","20","Select","Select",""],["","57664050658","METOPROL","25MG","180","Select","Select",""],["","00173071920","FLOVENT","110MCG","12","Select","Select",""],["","51862048601","TRIMETHOPRIM","100MG","30","Select","Select",""],["","51862048601","TRIMETHOPRIM ","TAB 100MG","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":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["No","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":""}]}]}