{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GARY M PERSINGER","gend":0,"add":"607 N ALLEGHANY AVE DOWNSTAIRS","city":"COVINGTON","state":"VA","zip":"24012-8510","dob":"1952-09-26","age":"","mstatus":"","insh":11009730,"cliId":"6JN9K52FA38","pno":5409602395,"cno":"","email":"","ename":"","eno":"","pphy":"VOEKLER, SUSANNE E","ppno":5409770900,"pcpadd":"4615 Huntridge Rd","pcpcity":"Roanoke","pcpstate":"VA","pcpzip":240128510,"pcpcounty":"","pcpid":"P0114066","pcpname":"LEWIS GALE PHYSICIANS LLC","plan":"VPHP - VIRGINIA PREMIER","program":"MEDICARE","lob":"DSNP","region":"ROANOKE\/ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"COVINGTON","mstate":"VA","mzip":"24426-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["I10","F10.10","Z76.0","F17.200","R47.9","B00.1","Z00.00","J31.0","Z01.812","Z20.828","J44.9","K13.21","Q38.3","Z23","Z12.11","R68.3","H54.7","R91.8","A41.9","R09.02"],"date":["2020-09-11","2020-09-11","2020-01-31","2021-05-25","2020-01-31","2020-01-31","2020-09-11","2020-11-04","2020-11-04","2020-11-04","2020-11-06","2020-12-21","2020-12-21","2020-09-11","2020-09-11","2020-09-11","2021-05-25","2021-05-30","2021-05-30","2021-05-30"],"priorHcc":["","","","","","","","","","","","","","","","","","","",""]}},{"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":[["","68645055554","LISINOPRIL","TAB 40MG","","Select","Select",""],["","574010770","CLOTRIMAZOLE","TRO 10MG","","Select","Select",""],["","60505004206","ACYCLOVIR","CAP 200MG","","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","","Select","Select",""],["","66993058697","FLUTIC\/SALME","AER 500\/50","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","","Select","Select",""],["","54327099","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","68645055554","LISINOPRIL ","TAB 40MG","90","Select","Select",""],["","54327099","FLUTICASONE ","SPR 50MCG","48","Select","Select",""],["","574010770","CLOTRIMAZOLE ","TRO 10MG","40","Select","Select",""],["","66993058697","FLUTIC\/SALME ","AER 500\/50","60","Select","Select",""],["","68645051554","AMLODIPINE ","TAB 5MG","30","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","Select","Select",""],["","68645056354","IBUPROFEN ","TAB 800MG","90","Select","Select",""],["","60505004206","ACYCLOVIR ","CAP 200MG","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":[[["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Select","Select","","","","","Select","",""],["No","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":""}]}]}