{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MICHAEL FRENCH JR","gend":0,"add":"2827 COVE ROAD NW ","city":"ROANOKE  ","state":"VA","zip":"24017-9998","dob":"1973-02-23","age":"","mstatus":"","insh":11013734,"cliId":"2UK7M16VF51","pno":5408921690,"cno":5408921690,"email":"","ename":"","eno":"","pphy":"BELL, VICTOR HOLLOWAY","ppno":5403620360,"pcpadd":"3716 Melrose Ave NW","pcpcity":"Roanoke  ","pcpstate":"VA","pcpzip":240172716,"pcpcounty":"","pcpid":"P0060152","pcpname":"NEW HORIZONS HEALTH CARE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"2827 COVE ROAD NW ","madd2":"","madd3":"","mcity":"ROANOKE  ","mstate":"VA","mzip":"24017-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F33.2","F43.10","I10","M10.072","K52.9","Z23","F20.0","G47.00","F31.9","F51.4","E66.9","F12.90","H52.00","K08.409","F10.20","Z87.898","Z68.31","R06.02","R05","F20.9","R45.851","R45.850","Z20.822","F10.94","F15.959","R07.2","R42","R19.7","E78.2","Z86.711","Z91.5","Z87.820","Z86.718","R07.9","R07.89","F14.24","F14.20","F10.24","F25.0","F41.0","F60.2","F60.89","F11.10","F19.94"],"date":["2021-09-23","2021-09-23","2021-09-14","2021-06-22","2020-10-02","2020-10-02","2020-07-24","2020-07-24","2021-09-11","2020-07-24","2020-07-24","2020-07-24","2020-07-24","2020-07-24","2020-07-24","2020-07-24","2020-07-24","2021-06-22","2021-06-22","2021-09-12","2021-09-14","2021-09-11","2021-09-14","2021-09-11","2021-09-11","2021-09-11","2021-09-11","2021-09-11","2021-09-14","2021-09-14","2021-09-14","2021-09-11","2021-09-11","2021-09-11","2021-09-11","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-19"],"priorHcc":[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":[["","50111043403","TRAZODONE","TAB 100MG","","Select","Select",""],["","63402030830","LATUDA","TAB 80MG","","Select","Select",""],["","13107015599","PAROXETINE","TAB 20MG","","Select","Select",""],["","59762532001","PRAZOSIN HCL","CAP 2MG","","Select","Select",""],["","68180098201","LISINOPRIL","TAB 30MG","","Select","Select",""],["","43547035550","LISINOPRIL ","TAB 30MG","90","Select","Select",""],["","50111043403","TRAZODONE ","TAB 100MG","60","Select","Select",""],["","59762532001","PRAZOSIN ","CAP 2MG","90","Select","Select",""],["","13107015599","PAROXETINE ","TAB 20MG","30","Select","Select",""],["","63402030830","LATUDA ","TAB 80MG","30","Select","Select",""],["","00093317431","ALBUTEROL ","E","8.5","Select","Select",""],["","59762532001","PRAZOSIN","2MG","90","Select","Select",""],["","00093317431","ALBUTEROL","E","8.5","Select","Select",""],["","47335032688","NALTREXONE","50MG","30","Select","Select",""],["","47335032688","NALTREXONE ","TAB 50MG","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":[[["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":""}]}]}