{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LOUIS TAYLOR","gend":0,"add":"426 E 16TH ST  ","city":"NORTH CHESTERFIELD","state":"VA","zip":"23224-9998","dob":"1954-07-20","age":"","mstatus":"","insh":11008779,"cliId":"9NX4GE9JK85","pno":8042373819,"cno":8042373819,"email":"","ename":"","eno":"","pphy":"BONNER, LLOYD ARDEN  ","ppno":8043258801,"pcpadd":"505 W Leigh St,Ste 205","pcpcity":"Richmond ","pcpstate":"VA","pcpzip":232203239,"pcpcounty":"","pcpid":"P0119141","pcpname":"PRIMARY HEALTH CARE ASSOCIATES","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"426 E 16TH ST  ","madd2":"","madd3":"","mcity":"NORTH CHESTERFIELD","mstate":"VA","mzip":"23224-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F33.2","F41.1","F33.1","F11.20","Z00.01","F41.8","I10","Z87.891","E11.9","B35.1","Z79.4","Z00.00","B20","R76.8","Z11.59","E11.69","K21.9","J30.2","I48.0","Z28.21","F32.2","F34.9","F41.9","Z77.22","E80.6","R30.0","R00.2","R94.31","E11.65","E11.21","F13.10","S09.90XA","S13.120A","M47.812","S39.91XA","J18.1","K44.9","K80.20","N28.1","S19.9XXA","S22.41XA","M41.9","S22.42XA","S02.831A","J90","M84.48XA","J98.11","I49.1","S61.411A","Z21","F32.9","B19.20","S22.41XD","E78.5","S60.511A","W11.XXXA","W12.XXXA","S49.92XA","R91.8","R09.89","S13.100A","L85.3","N30.00","H25.813","Z79.899","Z68.27","R39.12","R35.0","R35.1","R81","R82.998","R31.9","R33.9","I48.91","R39.198","N39.0","Z12.5","R31.29","S06.9X9A","V89.2XXA","I51.7","M79.641","M79.89","M54.2","R55","Y92.410","F43.0","R03.0","Z04.1"],"date":["2021-11-14","2021-10-19","2021-10-19","2020-08-12","2019-09-19","2019-09-19","2021-09-13","2021-03-17","2020-07-07","2021-02-02","2021-09-13","2019-09-19","2019-10-07","2019-10-07","2019-10-07","2021-02-02","2020-12-10","2020-11-03","2021-02-02","2020-11-03","2020-11-29","2019-12-02","2019-12-02","2019-12-02","2020-12-10","2021-03-03","2020-12-10","2020-12-10","2021-09-13","2021-02-02","2020-12-10","2019-12-21","2019-12-22","2019-12-21","2019-12-21","2019-12-21","2019-12-22","2019-12-21","2019-12-21","2019-12-21","2019-12-21","2020-07-07","2019-12-22","2019-12-22","2019-12-22","2019-12-22","2019-12-22","2019-12-22","2019-12-22","2019-12-22","2019-12-22","2019-12-22","2019-12-22","2021-09-13","2021-09-13","2019-12-22","2019-12-21","2019-12-21","2019-12-22","2019-12-22","2019-12-22","2021-02-02","2021-02-02","2020-07-07","2021-03-31","2020-07-07","2021-03-03","2021-03-03","2021-03-03","2021-03-03","2021-03-03","2021-03-03","2021-03-03","2021-03-17","2021-03-31","2021-03-31","2021-03-31","2021-03-31","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-10-19","2021-09-13","2021-09-13"],"priorHcc":[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":[["","43547040710","CLONAZEPAM","TAB 1MG","","Select","Select",""],["","88221905","LANTUS SOLOS","INJ 100\/ML","","Select","Select",""],["","65862059801","TAMSULOSIN","CAP 0.4MG","","Select","Select",""],["","65162027210","SMZ\/TMP DS","TAB 800-160","","Select","Select",""],["","31722070290","LOSARTAN POT","TAB 100MG","","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","193731221","CONTOUR","TES NEXT","","Select","Select",""],["","6027731","JANUVIA","TAB 100MG","","Select","Select",""],["","60505257909","ATORVASTATIN","TAB 20MG","","Select","Select",""],["","406055201","OXYCODONE","TAB 5MG","","Select","Select",""],["","67877022201","GABAPENTIN","CAP 100MG","","Select","Select",""],["","58657067601","CIPROFLOXACN","TAB 500MG","","Select","Select",""],["","193658621","MICROLET","MIS LANCETS","","Select","Select",""],["","57237000830","MIRTAZAPINE","TAB 15MG","","Select","Select",""],["","50458057930","XARELTO","TAB 20MG","","Select","Select",""],["","51672130005","AMMONIUM LAC","LOT 0.12","","Select","Select",""],["","60432026415","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","68382080501","TRAZODONE","TAB 50MG","","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","","Select","Select",""],["","69315090405","LORAZEPAM","TAB 0.5MG","","Select","Select",""],["","65862037401","ESCITALOPRAM","TAB 10MG","","Select","Select",""],["","67877056105","METFORMIN","TAB 500MG","","Select","Select",""],["","65162046510","IBUPROFEN","TAB 600MG","","Select","Select",""],["","8290320550","BD PEN NEEDL","MIS 32GX5\/32","","Select","Select",""],["","61958250101","BIKTARVY","TAB ","","Select","Select",""],["","65862007930","TERBINAFINE","TAB 250MG","","Select","Select",""],["","45802014167","CICLOPIROX","SOL 0.08","","Select","Select",""],["","51672129802","KETOCONAZOLE","CRE 0.02","","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","","Select","Select",""],["","43547040710","CLONAZEPAM ","TAB 1MG","60","Select","Select",""],["","88221905","LANTUS ","INJ 100\/ML","15","Select","Select",""],["","8290320550","BD  PEN NEEDL","MIS 32GX5\/32","100","Select","Select",""],["","65862059801","TAMSULOSIN ","CAP 0.4MG","30","Select","Select",""],["","193731221","CONTOUR ","TES NEXT","100","Select","Select",""],["","65862057490","MONTELUKAST ","TAB 10MG","90","Select","Select",""],["","6027731","JANUVIA ","TAB 100MG","30","Select","Select",""],["","57237000830","MIRTAZAPINE ","TAB 15MG","90","Select","Select",""],["","60505257909","ATORVASTATIN ","TAB 20MG","30","Select","Select",""],["","65162027210","SMZ\/TMP ","TAB 800-160","14","Select","Select",""],["","193658621","MICROLET ","MIS LANCETS","100","Select","Select",""],["","31722070290","LOSARTAN ","TAB 100MG","90","Select","Select",""],["","31722071390","PANTOPRAZOLE ","TAB 40MG","90","Select","Select",""],["","60432026415","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","406055201","OXYCODONE ","TAB 5MG","20","Select","Select",""],["","67877022201","GABAPENTIN ","CAP 100MG","21","Select","Select",""],["","65862007930","TERBINAFINE ","TAB 250MG","90","Select","Select",""],["","50458057930","XARELTO ","TAB 20MG","90","Select","Select",""],["","58657067601","CIPROFLOXACN ","TAB 500MG","20","Select","Select",""],["","65162046510","IBUPROFEN ","TAB 600MG","21","Select","Select",""],["","45802014167","CICLOPIROX ","SOL 0.08","6.6","Select","Select",""],["","51672130005","AMMONIUM ","LOT 0.12","225","Select","Select",""],["","51672129802","KETOCONAZOLE ","CRE 0.02","30","Select","Select",""],["","65162047810","NITROFURANTN ","CAP 100MG","20","Select","Select",""],["","65862037401","ESCITALOPRAM ","TAB 10MG","30","Select","Select",""],["","68382080501","TRAZODONE ","TAB 50MG","30","Select","Select",""],["","61958250101","BIKTARVY ","TAB ","30","Select","Select",""],["","69315090405","LORAZEPAM ","TAB 0.5MG","90","Select","Select",""],["","67877056105","METFORMIN ","500MG","180","Select","Select",""],["","00088221905","LANTUS","100\/ML","15","Select","Select",""],["","65162027210","SMZ\/TMP","800-160","14","Select","Select",""],["","31722070290","LOSARTAN","100MG","90","Select","Select",""],["","51672130005","AMMONIUM","0.12","225","Select","Select",""],["","16571020110","DICLOFENAC","75MG DR","45","Select","Select",""],["","16729017301","AMITRIPTYLIN ","TAB 50MG","30","Select","Select",""],["","08489831510","PEN  NEEDLES  ","MIS 32GX4MM","100","Select","Select",""],["","70010075401","METHOCARBAM ","TAB 500MG","21","Select","Select",""],["","16571020110","DICLOFENAC ","TAB 75MG DR","45","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":""}]}]}