{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JUANITA LESTER","gend":1,"add":"534 LOWRY DRIVE","city":"ABINGDON ","state":"VA","zip":"24210-3083","dob":"1931-10-17","age":"","mstatus":"","insh":11008728,"cliId":"7F56Q04WE56","pno":2766230839,"cno":2766230839,"email":"","ename":"","eno":"","pphy":"CAMARGO, EDGAR ","ppno":2766281106,"pcpadd":"212 E 106TH ST SETTLEMENT HEALTH","pcpcity":"NEW YORK ","pcpstate":"NY","pcpzip":100294007,"pcpcounty":"","pcpid":"P9058311","pcpname":"ABINGDON INTERNAL MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"APARTMENT E BOX 13","add3":"","madd1":"534 LOWRY DRIVE","madd2":"APARTMENT E BOX 13","madd3":"","mcity":"ABINGDON ","mstate":"VA","mzip":"24210-3083","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["G89.4","M06.9","M96.1","N39.0","Z79.899","I10","R53.1","F41.1","K57.32","M54.5","R69","E78.2","R53.83","R11.0","D53.9","E55.9","L98.9","R30.0","D04.71","Z01.818","Z03.818","Z20.822","C44.722","K21.9","I48.91","M19.90","C44.92","F11.20","D03.59","C44.719","C44.519","C44.511","L82.1","L57.0","L30.8","Z08","Z85.828","D48.5","C43.9","L81.4","Z12.83","C44.41","D04.4"],"date":["2021-10-21","2021-10-21","2021-10-21","2020-01-17","2021-01-28","2021-10-21","2020-11-25","2020-05-14","2020-05-14","2021-10-21","2021-08-25","2020-10-29","2019-11-20","2019-11-20","2019-11-20","2019-11-20","2021-01-05","2019-12-18","2021-01-28","2021-01-22","2021-01-22","2021-01-22","2021-01-28","2021-01-28","2021-01-28","2021-01-28","2021-10-21","2021-10-21","2021-05-20","2021-08-25","2021-05-20","2021-05-04","2021-07-06","2021-08-25","2021-05-04","2021-05-04","2021-05-04","2021-07-06","2021-10-21","2021-07-06","2021-07-06","2021-08-25","2021-07-06"],"priorHcc":[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":[["","16571041250","CIPROFLOXACN","TAB 500MG","","Select","Select",""],["","43547035311","LISINOPRIL","TAB 10MG","","Select","Select",""],["","378110101","PRAZOSIN HCL","CAP 1MG","","Select","Select",""],["","42858080101","MORPHINE SUL","TAB 15MG ER","","Select","Select",""],["","378057701","AMILOR\/HCTZ","TAB 18384","","Select","Select",""],["","93005401","BUSPIRONE","TAB 10MG","","Select","Select",""],["","406051205","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","31722071290","PANTOPRAZOLE","TAB 20MG","","Select","Select",""],["","68462025301","ROPINIROLE","TAB 0.25MG","","Select","Select",""],["","68462012605","GABAPENTIN","TAB 600MG","","Select","Select",""],["","603533731","PREDNISONE","PAK 5MG","","Select","Select",""],["","172572860","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","68382032001","POT CHLORIDE","TAB 10MEQ ER","","Select","Select",""],["","67877021620","CEFUROXIME","TAB 500MG","","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","","Select","Select",""],["","781571010","POT CL MICRO","TAB 10MEQ ER","","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","378668910","PANTOPRAZOLE ","TAB 40MG","90","Select","Select",""],["","93005401","BUSPIRONE ","TAB 10MG","60","Select","Select",""],["","378110101","PRAZOSIN ","CAP 1MG","90","Select","Select",""],["","378057701","AMILOR\/HCTZ ","TAB 18384","90","Select","Select",""],["","42858080101","MORPHINE ","TAB 15MG ER","30","Select","Select",""],["","406051205","OXYCOD\/APAP ","TAB 5-325MG","120","Select","Select",""],["","68462012605","GABAPENTIN ","TAB 600MG","120","Select","Select",""],["","68382032001","POT  CHLORIDE","TAB 10MEQ ER","90","Select","Select",""],["","16571041250","CIPROFLOXACN ","TAB 500MG","10","Select","Select",""],["","43547035311","LISINOPRIL ","TAB 10MG","90","Select","Select",""],["","67877021620","CEFUROXIME ","TAB 500MG","10","Select","Select",""],["","68180071160","CEFDINIR ","CAP 300MG","20","Select","Select",""],["","172572860","FAMOTIDINE ","TAB 20MG","180","Select","Select",""],["","68462025301","ROPINIROLE ","TAB 0.25MG","30","Select","Select",""],["","67877025115","TRIAMCINOLON ","CRE 0.001","45","Select","Select",""],["","781571010","POT  CL MICRO","TAB 10MEQ ER","90","Select","Select",""],["","50383070016","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","603533731","PREDNISONE ","PAK 5MG","48","Select","Select",""],["","00378110101","PRAZOSIN","1MG","90","Select","Select",""],["","42858080101","MORPHINE","15MG ER","30","Select","Select",""],["","67877025115","TRIAMCINOLON","0.001","45","Select","Select",""],["","66530024940","FLUOROURACIL","0.05","40","Select","Select",""],["","67877021905","CEPHALEXIN","500MG","28","Select","Select",""],["","27241009706","DULOXETINE","20MG","30","Select","Select",""],["","67877021905","CEPHALEXIN ","CAP 500MG","28","Select","Select",""],["","66530024940","FLUOROURACIL ","CRE 0.05","40","Select","Select",""],["","27241009706","DULOXETINE ","CAP 20MG","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":""}]}]}