{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PAUL J KENNEDY","gend":0,"add":"398 KENNEDY HOLLOW","city":"CASTLEWOOD  ","state":"VA","zip":"24224-9998","dob":"1969-12-15","age":"","mstatus":"","insh":11009113,"cliId":"1WN5XY0UG83","pno":2767627908,"cno":"","email":"","ename":"","eno":"","pphy":"RENFRO, THOMAS E  ","ppno":2767622300,"pcpadd":"16431 Wise St","pcpcity":"Saint Paul  ","pcpstate":"VA","pcpzip":242833537,"pcpcounty":"","pcpid":"P9059103","pcpname":"THOMAS E RENFRO COMMUNITY CLINIC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"","add3":"","madd1":"398 KENNEDY HOLLOW","madd2":"","madd3":"","mcity":"CASTLEWOOD  ","mstate":"VA","mzip":"24224-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["I10","T56.891S","F25.9","F31.9","R73.01","E04.2","K22.70","K21.9","R25.9","E53.8","D48.5","D22.5","L81.4","D22.62","D22.61","E78.5","E04.1","R27.0","Z79.899","Z51.81","E87.6","N17.9","F20.9","Z81.8","R89.2","T56.891A","E07.9","R79.0","R41.82","G47.00","F41.9","E05.90","R45.6","Z20.822","Z01.84","R45.1","M62.82","E87.1","E86.0","F31.2","G21.0","G25.9","M54.9","R21","W01.0XXA","Y92.230","K59.00","R33.9","N25.1","D64.9","E03.9","E86.9","I12.9","N18.2","N13.2","R35.8","E87.0","R06.89","K59.09","G20","N13.9","R25.1","J93.11","I48.0","J44.9","E11.9","I25.10","G47.33","I42.8","I50.22","Z95.810","J96.21","D50.9","E86.1","I95.9","N13.30","N13.8","T79.6XXA","R10.9","R07.9","R10.84","M62.81","R05","M79.632","M25.522","R73.9"],"date":["2021-06-09","2020-09-21","2021-05-07","2021-05-07","2021-03-09","2021-03-09","2020-09-21","2021-03-13","2021-05-06","2021-03-13","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2021-03-09","2021-03-09","2021-03-09","2021-02-18","2019-10-29","2021-03-09","2021-05-07","2021-05-06","2019-11-29","2019-11-29","2019-11-29","2021-02-18","2021-02-18","2021-05-03","2021-02-17","2021-02-19","2021-10-27","2021-02-18","2021-05-01","2021-02-18","2021-02-18","2021-03-13","2021-03-29","2021-03-29","2021-02-19","2021-02-19","2021-02-19","2021-02-19","2021-02-19","2021-02-19","2021-02-19","2021-05-07","2021-05-08","2021-06-09","2021-05-06","2021-05-06","2021-05-07","2021-05-08","2021-06-09","2021-05-01","2021-05-07","2021-05-07","2021-05-07","2021-09-02","2021-05-03","2021-05-03","2021-05-07","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-06","2021-05-07","2021-05-07","2021-04-12","2021-04-29","2021-05-01","2021-05-05","2021-05-10","2021-09-24","2021-08-12","2021-08-12","2021-10-07"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",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":[["","51672400501","CARBAMAZEPIN","TAB 200MG","","Select","Select",""],["","68382007901","HALOPERIDOL","TAB 5MG","","Select","Select",""],["","378395005","ATORVASTATIN","TAB 10MG","","Select","Select",""],["","456140530","BYSTOLIC","TAB 5MG","","Select","Select",""],["","68462022110","LITHIUM CARB","CAP 300MG","","Select","Select",""],["","63304073530","ESOMEPRA MAG","CAP 40MG DR","","Select","Select",""],["","68382018001","BUSPIRONE","TAB 5MG","","Select","Select",""],["","603243821","BENZTROPINE","TAB 1MG","","Select","Select",""],["","65162090103","ARIPIPRAZOLE","TAB 20MG","","Select","Select",""],["","59746030632","OLANZAPINE","TAB 5MG ODT","","Select","Select",""],["","65862001901","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","904661561","DIVALPROEX","CAP 125MG","","Select","Select",""],["","23155007001","METHIMAZOLE","TAB 5MG","","Select","Select",""],["","68180071909","AMLODIPINE","TAB 2.5MG","","Select","Select",""],["","904600861","LORAZEPAM","TAB 1MG","","Select","Select",""],["","16729018301","HYDROCHLOROT","TAB 25MG","","Select","Select",""],["","55111025660","ZIPRASIDONE","CAP 20MG","","Select","Select",""],["","65862055990","PANTOPRAZOLE","TAB 20MG","","Select","Select",""],["","33332032001","AFLURIA QUAD","INJ 2020-21","","Select","Select",""],["","58160089652","FLUARIX QUAD","INJ 2019-20","","Select","Select",""],["","574029201","AMILORIDE","TAB 5MG","","Select","Select",""],["","245531901","KLOR-CON M20","TAB 20MEQ ER","","Select","Select",""],["","68180052002","LISINOP\/HCTZ","TAB 20-25MG","","Select","Select",""],["","904670561","PROPRANOLOL","TAB 20MG","","Select","Select",""],["","23155050105","HYDROXYZ HCL","TAB 25MG","","Select","Select",""],["","65862078430","ESOMEPRA ","CAP 40MG DR","90","Select","Select",""],["","603243821","BENZTROPINE ","TAB 1MG","60","Select","Select",""],["","68382018001","BUSPIRONE ","TAB 5MG","60","Select","Select",""],["","68382007901","HALOPERIDOL ","TAB 5MG","30","Select","Select",""],["","51672400501","CARBAMAZEPIN ","TAB 200MG","120","Select","Select",""],["","68462022110","LITHIUM ","CAP 300MG","90","Select","Select",""],["","456140530","BYSTOLIC ","TAB 5MG","30","Select","Select",""],["","68180072003","AMLODIPINE ","TAB 5MG","90","Select","Select",""],["","378395005","ATORVASTATIN ","TAB 10MG","90","Select","Select",""],["","904664361","QUETIAPINE ","TAB 400MG","26","Select","Select",""],["","904661561","DIVALPROEX ","CAP 125MG","446","Select","Select",""],["","574029201","AMILORIDE ","TAB 5MG","21","Select","Select",""],["","65162089809","ARIPIPRAZOLE ","TAB 10MG","7","Select","Select",""],["","51079075920","ATENOLOL ","TAB 25MG","33","Select","Select",""],["","23155007001","METHIMAZOLE ","TAB 5MG","26","Select","Select",""],["","904600861","LORAZEPAM ","TAB 1MG","27","Select","Select",""],["","59746030732","OLANZAPINE ","TAB 10MG ODT","1","Select","Select",""],["","65862001901","CEPHALEXIN ","CAP 500MG","1","Select","Select",""],["","781320895","CEFTRIAXONE ","INJ 1GM","9","Select","Select",""],["","904595961","CLINDAMYCIN ","CAP 150MG","123","Select","Select",""],["","10702016901","DESMOPRESSIN ","TAB 0.1MG","23","Select","Select",""],["","245531901","KLOR-CON ","TAB 20MEQ ER","2","Select","Select",""],["","65862055990","PANTOPRAZOLE ","TAB 20MG","29","Select","Select",""],["","904670561","PROPRANOLOL ","TAB 20MG","23","Select","Select",""],["","16729018301","HYDROCHLOROT ","TAB 25MG","8","Select","Select",""],["","121115440","LACTULOSE ","SOL 10GM\/15","480","Select","Select",""],["","45963043864","ENULOSE ","SOL 10GM\/15","473","Select","Select",""],["","68180052002","LISINOP\/HCTZ ","TAB 20-25MG","90","Select","Select",""],["","55111025660","ZIPRASIDONE ","CAP 20MG","5","Select","Select",""],["","33332032001","AFLURIA ","INJ 2020-21","0.5","Select","Select",""],["","58160089652","FLUARIX ","INJ 2019-20","0.5","Select","Select",""],["","68462015713","ONDANSETRON ","4MG ODT","1","Select","Select",""],["","121467540","VALPROIC ","250\/5ML","375","Select","Select",""],["","64764024060","AMITIZA ","24MCG","36","Select","Select",""],["","23155050105","HYDROXYZ ","25MG","12","Select","Select",""],["","68382013914","TOPIRAMATE ","50MG","1","Select","Select",""],["","65862078430","ESOMEPRA","40MG DR","90","Select","Select",""],["","68462022110","LITHIUM","300MG","90","Select","Select",""],["","00904663961","QUETIAPINE","50MG","11","Select","Select",""],["","69097012303","TOPIRAMATE","50MG","12","Select","Select",""],["","10702016901","DESMOPRESSIN","0.1MG","122","Select","Select",""],["","65862084501","CLOZAPINE","50MG","6","Select","Select",""],["","00121115440","LACTULOSE","10GM\/15","53","Select","Select",""],["","00121168016","POT CHLORIDE","0.1","473","Select","Select",""],["","00245531901","KLOR-CON","20MEQ ER","4","Select","Select",""],["","51079075920","ATENOLOL","25MG","60","Select","Select",""],["","00121135000","VALPROIC","250\/5ML","2","Select","Select",""],["","45963043864","ENULOSE","10GM\/15","473","Select","Select",""],["","64764024060","AMITIZA","24MCG","36","Select","Select",""],["","00781320895","CEFTRIAXONE","1GM","9","Select","Select",""],["","00904595961","CLINDAMYCIN","150MG","123","Select","Select",""],["","68462015713","ONDANSETRON","4MG ODT","1","Select","Select",""],["","33332032001","AFLURIA","2020-21","0.5","Select","Select",""],["","23155050105","HYDROXYZ","25MG","12","Select","Select",""],["","58160089652","FLUARIX","2019-20","0.5","Select","Select",""],["","57664078686","CLONAZEP","1MG","8","Select","Select",""],["","50383070016","FLUTICASONE","50MCG","16","Select","Select",""],["","68180065208","DOXYCYC","100MG","28","Select","Select",""],["","00093541984","CLOZAPINE ","TAB 100\/ODT","12","Select","Select",""],["","00121168016","POT  CHLORIDE","SOL 0.1","473","Select","Select",""],["","50383070016","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","57664078686","CLONAZEP ","TAB 1MG","39","Select","Select",""],["","68180065208","DOXYCYC ","CAP 100MG","28","Select","Select",""],["","17478021505","ATROPINE ","SOL 1% OP","5","Select","Select",""],["","00904668961","METFORMIN ","TAB 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","",""],["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":""}]}]}