{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LATOYA T HURDLE","gend":1,"add":"6721 IRON  CREEK CIR #102  ","city":"CHESTER  ","state":"VA","zip":"23831-9998","dob":"1979-05-24","age":"","mstatus":"","insh":11010558,"cliId":"1WM9VK6MA18","pno":8047291876,"cno":8047291876,"email":"","ename":"","eno":"","pphy":"BECKWITH, DOUGLAS E  ","ppno":8047962373,"pcpadd":"12901 Briggs Rd","pcpcity":"Chester  ","pcpstate":"VA","pcpzip":238315335,"pcpcounty":"","pcpid":"P0151332","pcpname":"SOUTHSIDE PHYSICIANS NETWORK-FAMILY MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"N","ano":"","add2":"","add3":"","madd1":"6721 IRON  CREEK CIR #102  ","madd2":"","madd3":"","mcity":"CHESTER  ","mstate":"VA","mzip":"23831-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["J02.9","F17.200","R13.10","T78.40XA","I10","E55.9","R73.9","U07.1","F31.9","E78.5","G47.00","I51.7","R00.2","R06.02","R07.89","R07.9","R79.89","J20.9","R73.09","F41.9","Z74.3","R22.0","J32.9","R09.82","R09.81","R22.1","Z77.120","K21.9","L02.01","L02.91","M79.89","B97.81","K14.8","T46.4X5A"],"date":["2021-08-19","2021-09-20","2021-09-03","2021-08-23","2021-09-03","2021-09-01","2020-12-01","2020-12-01","2021-08-12","2021-09-03","2021-03-16","2021-04-02","2021-04-02","2021-08-23","2021-04-02","2021-04-02","2021-04-02","2021-05-26","2021-08-12","2021-08-15","2021-08-23","2021-08-23","2021-08-15","2021-08-15","2021-08-15","2021-08-17","2021-08-17","2021-09-03","2021-09-20","2021-09-20","2021-09-20","2021-08-12","2021-08-23","2021-08-23"],"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":[["","591544305","PREDNISONE","TAB 20MG","","Select","Select",""],["","57664050083","MIRTAZAPINE","TAB 30MG","","Select","Select",""],["","93077198","PRAVASTATIN","TAB 10MG","","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","45802005535","TRIAMCINOLON","OIN 0.001","","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","","Select","Select",""],["","93598627","EPINEPHRINE","INJ 0.3MG","","Select","Select",""],["","65862070360","ZIPRASIDONE","CAP 40MG","","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","","Select","Select",""],["","172572860","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","93077198","PRAVASTATIN ","TAB 10MG","30","Select","Select",""],["","591544305","PREDNISONE ","TAB 20MG","10","Select","Select",""],["","65862070360","ZIPRASIDONE ","CAP 40MG","30","Select","Select",""],["","57664050083","MIRTAZAPINE ","TAB 30MG","30","Select","Select",""],["","45802005535","TRIAMCINOLON ","OIN 0.001","15","Select","Select",""],["","65862018601","CLINDAMYCIN ","CAP 300MG","28","Select","Select",""],["","64380080707","IBUPROFEN ","TAB 800MG","15","Select","Select",""],["","50383077504","LIDOCAINE ","SOL 2% VISC","100","Select","Select",""],["","172572860","FAMOTIDINE ","TAB 20MG","20","Select","Select",""],["","93598627","EPINEPHRINE ","INJ 0.3MG","2","Select","Select",""],["","65862050220","AMOX\/K ","500-125","20","Select","Select",""],["","00093031101","LOPERAMIDE","2MG","40","Select","Select",""],["","65862050220","AMOX\/K","500-125","20","Select","Select",""],["","00527193206","CLARITHROMYC","500MG","20","Select","Select",""],["","50742026001","NIFEDIPINE","30MG ER","90","Select","Select",""],["","62175061743","PANTOPRAZOLE","40MG","60","Select","Select",""],["","50742061610","METOPROL","50MG ER","90","Select","Select",""],["","68180012202","CEPHALEXIN","500MG","40","Select","Select",""],["","00093005805","TRAMADOL","50MG","15","Select","Select",""],["","65162018910","NAPROXEN","375MG","15","Select","Select",""],["","53489011905","DOXYCYCL","100MG","20","Select","Select",""],["","62175061743","PANTOPRAZOLE ","TAB 40MG","60","Select","Select",""],["","65162018910","NAPROXEN ","TAB 375MG","15","Select","Select",""],["","00093031101","LOPERAMIDE ","CAP 2MG","40","Select","Select",""],["","00527193206","CLARITHROMYC ","TAB 500MG","20","Select","Select",""],["","50742026001","NIFEDIPINE ","TAB 30MG ER","90","Select","Select",""],["","53489011905","DOXYCYCL ","CAP 100MG","20","Select","Select",""],["","68180012202","CEPHALEXIN ","CAP 500MG","40","Select","Select",""],["","00093005805","TRAMADOL ","TAB 50MG","15","Select","Select",""],["","50742061610","METOPROL ","TAB 50MG ER","90","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":""}]}]}