{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JANNETH D WALKER","gend":1,"add":"1568 STULTZ RD ","city":"MARTINSVILLE","state":"VA","zip":"24112-9998","dob":"1961-11-23","age":"","mstatus":"","insh":11009384,"cliId":"7RQ1AW7MW80","pno":2762263562,"cno":2762263562,"email":"","ename":"","eno":"","pphy":"AARON, CAREN T ","ppno":2766660452,"pcpadd":"319 Hospital Dr Ste 101","pcpcity":"Martinsville","pcpstate":"VA","pcpzip":241121928,"pcpcounty":"","pcpid":"P9058808","pcpname":"MARTINSVILLE PHYSICIAN PRACTICES LLC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1568 STULTZ RD ","madd2":"","madd3":"","mcity":"MARTINSVILLE","mstate":"VA","mzip":"24112-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["G24.01","G25.4","T43.595A","R47.01","R42","F31.9","I67.82","M79.7","R29.6","Z91.81","R94.31","Z72.0","E66.9","Z68.31","D25.9","R90.82","Z88.0","R26.9","R06.00","R29.818","R41.0","T43.505A","I63.89","F33.1","G89.4","F33.40","M25.569","I10","N39.490","F91.3","F11.921","T42.4X5A","E86.0","R41.82","R41.3","T40.2X1A","Y92.007","G92","J96.21","I50.30","I11.0","G89.29","T42.4X1A","F19.10","F17.210","Z79.899","Z79.82","Z98.51","T40.601A","G25.89","F06.33","M12.9","J30.1","F32.9","R60.9","D64.9","Z90.49","Z90.89","R60.0","M17.12","G47.00","F33.3","E55.9","R79.89","E07.9","D51.9","E78.9","Z13.9","G44.209","M50.13","S00.03XA","M54.2","V49.59XA","S13.4XXA","M25.521","R51.9","R40.4","T50.904A","R09.02","R06.89","Z20.822","Z20.828","Z79.891","T43.501A","S09.90XA","S19.9XXA","E66.01","R30.0","R52","R45.851","F25.0","R46.2","Z98.84","R44.1","F33.2","Z01.419","Z12.31","Z91.89","Z98.890","M79.601","R22.31","H25.13","H52.4","Z00.00"],"date":["2020-04-09","2020-01-12","2020-01-13","2020-01-12","2020-01-12","2021-05-05","2020-01-13","2021-09-15","2020-01-12","2020-01-12","2021-05-05","2021-11-24","2021-05-05","2020-01-12","2021-05-05","2020-01-12","2021-09-15","2020-01-13","2020-01-12","2020-01-12","2021-05-05","2020-01-12","2020-01-13","2021-09-10","2021-08-02","2020-01-16","2020-11-03","2021-09-15","2021-11-06","2020-09-08","2020-03-24","2020-03-24","2020-03-24","2021-05-05","2020-03-24","2021-05-06","2020-03-24","2021-05-05","2020-03-24","2020-03-24","2020-03-24","2021-09-15","2021-05-05","2021-05-05","2021-09-15","2021-09-15","2021-09-15","2020-03-24","2020-03-26","2021-03-02","2021-08-02","2021-08-02","2020-04-29","2021-03-08","2020-05-17","2021-09-10","2021-03-08","2020-05-17","2020-05-17","2020-09-03","2021-08-02","2021-10-26","2021-01-05","2021-01-05","2021-01-05","2021-01-05","2021-01-05","2021-01-05","2021-04-21","2021-06-22","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-03-08","2021-05-05","2021-05-05","2021-05-05","2021-05-05","2021-09-15","2021-05-05","2021-05-05","2021-05-05","2021-03-08","2021-03-08","2021-06-22","2021-05-20","2021-03-08","2021-09-10","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2021-09-21","2021-11-24","2021-11-24","2021-11-24","2021-11-24","2021-11-24","2021-11-24","2021-11-24","2021-11-24","2021-11-17"],"priorHcc":["","","","","","","","","","","",null,"","","","","","","","","","","","","","","","",null,"","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",null,"","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",null,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":[["","59762372104","ALPRAZOLAM","TAB 1MG","","Select","Select",""],["","603243821","BENZTROPINE","TAB 1MG","","Select","Select",""],["","781540192","ROSUVASTATIN","TAB 10MG","","Select","Select",""],["","93007301","ZOLPIDEM","TAB 5MG","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","16729014701","QUETIAPINE","TAB 100MG","","Select","Select",""],["","53746011005","HYDROCO\/APAP","TAB 10-325MG","","Select","Select",""],["","13668021890","ARIPIPRAZOLE","TAB 10MG","","Select","Select",""],["","54327099","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","185012901","BUMETANIDE","TAB 1MG","","Select","Select",""],["","173068220","VENTOLIN HFA","AER ","","Select","Select",""],["","228255106","DICLOFENAC","TAB 75MG DR","","Select","Select",""],["","57237001999","DULOXETINE","CAP 60MG","","Select","Select",""],["","67877019890","AMLODIPINE","TAB 5MG","","Select","Select",""],["","591544201","PREDNISONE","TAB 10MG","","Select","Select",""],["","69547035302","NARCAN","SPR ","","Select","Select",""],["","57664037088","OXYCODONE","TAB 10MG","","Select","Select",""],["","57664037088","OXYCODONE ","TAB 10MG","90","Select","Select",""],["","781540192","ROSUVASTATIN ","TAB 10MG","30","Select","Select",""],["","603243821","BENZTROPINE ","TAB 1MG","60","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","Select","Select",""],["","59762372104","ALPRAZOLAM ","TAB 1MG","120","Select","Select",""],["","16729014701","QUETIAPINE ","TAB 100MG","30","Select","Select",""],["","53746011005","HYDROCO\/APAP ","TAB 10-325MG","90","Select","Select",""],["","13668021890","ARIPIPRAZOLE ","TAB 10MG","90","Select","Select",""],["","93007301","ZOLPIDEM ","TAB 5MG","30","Select","Select",""],["","185012901","BUMETANIDE ","TAB 1MG","90","Select","Select",""],["","54327099","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","228255106","DICLOFENAC ","TAB 75MG DR","60","Select","Select",""],["","57237001999","DULOXETINE ","CAP 60MG","60","Select","Select",""],["","173068220","VENTOLIN ","AER ","18","Select","Select",""],["","67877019890","AMLODIPINE ","TAB 5MG","30","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","55111012601","CIPROFLOXACN ","250MG","6","Select","Select",""],["","591544201","PREDNISONE ","10MG","30","Select","Select",""],["","59310057922","PROAIR","","8.5","Select","Select",""],["","00173068220","VENTOLIN","","18","Select","Select",""],["","55111012601","CIPROFLOXACN","250MG","6","Select","Select",""],["","68382010601","DIVALPROEX","125MG","120","Select","Select",""],["","00904636161","RISPERIDONE","3MG","30","Select","Select",""],["","00904636161","RISPERIDONE ","TAB 3MG","30","Select","Select",""],["","68382010601","DIVALPROEX ","CAP 125MG","120","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","",""],["Yes","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":""}]}]}