{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BARBARA A HOLDEN","gend":1,"add":"1158 HURST DR # 9","city":"VINTON","state":"VA","zip":241799999,"dob":"1952-05-14","age":"","mstatus":"","insh":11013606,"cliId":"9G32W93EQ14","pno":5405568722,"cno":5405210329,"email":"","ename":"","eno":"","pphy":"ANDREWS, CLARKE B","ppno":5409925994,"pcpadd":"1935 WEST MAIN STREET","pcpcity":"SALEM","pcpstate":"VA","pcpzip":241533109,"pcpcounty":"","pcpid":"P0125174","pcpname":"CARILION FAMILY MEDICINE PARKWAY PHYSICIANS VINT","plan":"VPHP - VIRGINIA PREMIER","program":"Medicare","lob":"DSNP","region":"ROANOKE\/ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["E11.65","F41.1","Z79.891","R10.9","K86.1","G89.3","Z79.899","G89.4","F33.1","F43.22","G47.9","E11.9","E03.4","G40.909","I10","J43.1","C50.411","F60.3","E78.5","Z17.0","M16.12","M16.10","R07.81","F32.1","N64.9","F17.200","Z23","E11.59","G47.00","F17.210","M51.36","I25.10","G40.919","Z85.3","Z95.828","Z79.84","Z79.82","J44.9","Z92.3","Z68.25","R25.2","M79.604","M79.605","F43.21","I73.9"],"date":["2020-05-11","2021-04-29","2020-12-30","2020-12-30","2021-04-27","2020-12-30","2020-12-30","2021-04-27","2020-05-19","2020-05-19","2020-05-19","2021-05-13","2020-07-09","2020-07-29","2021-04-29","2020-07-29","2020-07-29","2020-10-01","2020-07-30","2020-07-29","2020-08-05","2020-12-30","2020-08-28","2020-10-01","2021-04-27","2021-04-29","2020-10-28","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2020-07-30","2021-04-29","2021-03-11","2021-03-11","2021-04-29","2021-05-13"],"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":[["","13107003234","MIRTAZAPINE","TAB 45MG","","Select","Select",""],["","597015230","JARDIANCE","TAB 10MG","","Select","Select",""],["","172208380","HYDROCHLOROT","TAB 25MG","","Select","Select",""],["","245531911","KLOR-CON M20","TAB 20MEQ ER","","Select","Select",""],["","76282066339","DICLOFENAC","GEL 0.01","","Select","Select",""],["","60505132305","PRAVASTATIN","TAB 80MG","","Select","Select",""],["","406012501","HYDROCO\/APAP","TAB 10-325MG","","Select","Select",""],["","16714085201","METOPROL SUC","TAB 25MG ER","","Select","Select",""],["","93005405","BUSPIRONE","TAB 10MG","","Select","Select",""],["","68382013610","LOSARTAN POT","TAB 50MG","","Select","Select",""],["","93506110","HYDROXYZ HCL","TAB 25MG","","Select","Select",""],["","13668010410","ISOSORB MONO","TAB 30MG ER","","Select","Select",""],["","378306677","FENOFIBRATE","TAB 145MG","","Select","Select",""],["","54023525","MORPHINE SUL","TAB 15MG","","Select","Select",""],["","68645059154","ATORVASTATIN","TAB 20MG","","Select","Select",""],["","169406013","VICTOZA","INJ 18MG\/3ML","","Select","Select",""],["","832532510","POT CL MICRO","TAB 20MEQ ER","","Select","Select",""],["","23155010405","METFORMIN","TAB 1000MG","","Select","Select",""],["","65862069201","PHENYTOIN EX","CAP 100MG","","Select","Select",""],["","193731221","CONTOUR","TES NEXT","","Select","Select",""],["","8214055080","PEN NEEDLES","MIS 31GX3\/16","","Select","Select",""],["","27241005203","ARIPIPRAZOLE","TAB 5MG","","Select","Select",""],["","13107003234","MIRTAZAPINE ","TAB 45MG","90","Select","Select",""],["","54023525","MORPHINE ","TAB 15MG","30","Select","Select",""],["","406012501","HYDROCO\/APAP ","TAB 10-325MG","120","Select","Select",""],["","60505132309","PRAVASTATIN ","TAB 80MG","90","Select","Select",""],["","13668010401","ISOSORB ","TAB 30MG ER","90","Select","Select",""],["","65862069201","PHENYTOIN ","CAP 100MG","450","Select","Select",""],["","597015230","JARDIANCE ","TAB 10MG","90","Select","Select",""],["","172208380","HYDROCHLOROT ","TAB 25MG","90","Select","Select",""],["","245531911","KLOR-CON ","TAB 20MEQ ER","90","Select","Select",""],["","42806066405","BUSPIRONE ","TAB 15MG","90","Select","Select",""],["","68382013610","LOSARTAN ","TAB 50MG","30","Select","Select",""],["","76282066339","DICLOFENAC ","GEL 0.01","400","Select","Select",""],["","16714085201","METOPROL ","TAB 25MG ER","30","Select","Select",""],["","378306677","FENOFIBRATE ","TAB 145MG","30","Select","Select",""],["","93506110","HYDROXYZ ","TAB 25MG","90","Select","Select",""],["","68645059154","ATORVASTATIN ","TAB 20MG","90","Select","Select",""],["","169406013","VICTOZA ","INJ 18MG\/3ML","18","Select","Select",""],["","8214055080","PEN  NEEDLES  ","MIS 31GX3\/16","100","Select","Select",""],["","65862001005","METFORMIN ","TAB 1000MG","180","Select","Select",""],["","193731221","CONTOUR ","TES NEXT","100","Select","Select",""],["","832532510","POT  CL MICRO","TAB 20MEQ ER","30","Select","Select",""],["","27241005203","ARIPIPRAZOLE ","TAB 5MG","30","Select","Select",""],["","50458014130","INVOKANA ","300MG","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":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","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":""}]}]}