{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMES J YOPP","gend":0,"add":"5505COLES ROAD ","city":"ELLSTON  ","state":"VA","zip":"24087-9998","dob":"1975-12-23","age":"","mstatus":"","insh":11012537,"cliId":"3WG1W60KE07","pno":4349444896,"cno":4342486743,"email":"","ename":"","eno":"","pphy":"DEHLI, TODD H  ","ppno":5402977181,"pcpadd":"1613 Oakwood St,Ste 101","pcpcity":"Bedford  ","pcpstate":"VA","pcpzip":245231213,"pcpcounty":"","pcpid":"P9338915","pcpname":"CENTRA MEDICAL GROUP","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"5505COLES ROAD ","madd2":"","madd3":"","mcity":"ELLSTON  ","mstate":"VA","mzip":"24087-9998","pcpfaxno":4343762081,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F20.9","E11.9","F17.210","F99","I10","F25.0","E11.65","F25.9","E03.9","E78.5","R13.10","M54.5","K04.7","R39.81","I63.9","Z23","Z72.0","R12","F20.0","R74.01","E11.69","R41.82","R94.31","T42.6X1A","Y92.9","G93.41","T45.0X1A","Z20.822","E66.9","T44.3X1A","K21.9","F79","E78.1","E86.1","G93.40","R39.9","F31.60","Z86.39","F31.9","Z79.899"],"date":["2021-10-11","2021-10-19","2021-10-05","2020-03-17","2021-10-11","2021-10-05","2021-08-20","2020-06-05","2021-10-11","2021-10-11","2020-06-05","2020-06-05","2020-08-05","2021-10-09","2021-10-09","2020-10-08","2021-06-18","2021-06-18","2021-10-19","2021-02-24","2021-08-20","2021-10-05","2021-10-07","2021-10-06","2021-10-05","2021-10-05","2021-10-11","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-06","2021-10-05","2021-10-11","2021-10-06","2021-10-06","2021-10-11","2021-10-28"],"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":[["","67877045005","TAMSULOSIN","CAP 0.4MG","","Select","Select",""],["","27241000150","RISPERIDONE","TAB 1MG","","Select","Select",""],["","86227030105","SURE COMFORT","MIS LANCETS","","Select","Select",""],["","65702010110","ACCU-CHEK","KIT AVIVA PL","","Select","Select",""],["","57237004805","DIVALPROEX","TAB 500MG DR","","Select","Select",""],["","23155010210","METFORMIN","TAB 500MG","","Select","Select",""],["","50111043403","TRAZODONE","TAB 100MG","","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","","Select","Select",""],["","76385010301","BENZTROPINE","TAB 0.5MG","","Select","Select",""],["","67877019810","AMLODIPINE","TAB 5MG","","Select","Select",""],["","591024105","LORAZEPAM","TAB 1MG","","Select","Select",""],["","378668910","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","378032701","HALOPERIDOL","TAB 5MG","","Select","Select",""],["","115180302","HYDROXYZ PAM","CAP 25MG","","Select","Select",""],["","67877049005","EZETIMIBE","TAB 10MG","","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","","Select","Select",""],["","55111012105","ATORVASTATIN","TAB 10MG","","Select","Select",""],["","69238183207","LEVOTHYROXIN","TAB 75MCG","","Select","Select",""],["","61442010310","DICLOFENAC","TAB 75MG DR","","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","406051205","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","","Select","Select",""],["","66685100100","AMOX\/K CLAV","TAB 875-125","","Select","Select",""],["","64380080707","IBUPROFEN","TAB 800MG","","Select","Select",""],["","116200116","CHLORHEX GLU","SOL 0.0012","","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","","Select","Select",""],["","69238183207","LEVOTHYROXIN ","TAB 75MCG","90","Select","Select",""],["","55111012105","ATORVASTATIN ","TAB 10MG","90","Select","Select",""],["","65862056090","PANTOPRAZOLE ","TAB 40MG","90","Select","Select",""],["","55111053405","DIVALPROEX ","TAB 500MG ER","360","Select","Select",""],["","43547034350","RISPERIDONE ","TAB 3MG","180","Select","Select",""],["","68180072003","AMLODIPINE ","TAB 5MG","180","Select","Select",""],["","68180098103","LISINOPRIL ","TAB 20MG","90","Select","Select",""],["","603243721","BENZTROPINE ","TAB 0.5MG","10","Select","Select",""],["","378032701","HALOPERIDOL ","TAB 5MG","15","Select","Select",""],["","591024105","LORAZEPAM ","TAB 1MG","540","Select","Select",""],["","378718505","METFORMIN ","TAB 500MG","90","Select","Select",""],["","781569031","EZETIMIBE ","TAB 10MG","90","Select","Select",""],["","68382080601","TRAZODONE ","TAB 100MG","270","Select","Select",""],["","86227030105","SURE ","MIS LANCETS","100","Select","Select",""],["","65702010110","ACCU-CHEK ","KIT AVIVA PL","1","Select","Select",""],["","66685100100","AMOX\/K ","TAB 875-125","14","Select","Select",""],["","50383077504","LIDOCAINE ","SOL 2% VISC","100","Select","Select",""],["","67877045005","TAMSULOSIN ","CAP 0.4MG","30","Select","Select",""],["","115180302","HYDROXYZ ","CAP 25MG","60","Select","Select",""],["","61442010310","DICLOFENAC ","TAB 75MG DR","60","Select","Select",""],["","65862018601","CLINDAMYCIN ","CAP 300MG","28","Select","Select",""],["","64380080707","IBUPROFEN ","TAB 800MG","20","Select","Select",""],["","406051205","OXYCOD\/APAP ","TAB 5-325MG","12","Select","Select",""],["","59746000103","METHYLPRED ","TAB 4MG","21","Select","Select",""],["","116200116","CHLORHEX ","SOL 0.0012","473","Select","Select",""],["","172572860","FAMOTIDINE ","TAB 20MG","60","Select","Select",""],["","57237002801","AMOXICILLIN ","TAB 500MG","30","Select","Select",""],["","66993001968","ALBUTEROL ","AER HFA","18","Select","Select",""],["","86227030105","SURE","LANCETS","100","Select","Select",""],["","66685100100","AMOX\/K","875-125","14","Select","Select",""],["","00115180302","HYDROXYZ","25MG","60","Select","Select",""],["","00116200116","CHLORHEX","0.0012","473","Select","Select",""],["","55111026281","OLANZAPINE ","TAB 5MG ODT","60","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","",""],["No","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":""}]}]}