{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIMBERLY O HUTCHENS","gend":1,"add":"1433 CREASEY CHAPEL RD  ","city":"STUART","state":"VA","zip":"24171-9998","dob":"1975-10-17","age":"","mstatus":"","insh":11013777,"cliId":"2Q29GR3NA41","pno":2766928872,"cno":2766928872,"email":"","ename":"","eno":"","pphy":"COLE, RICHARD C","ppno":2766944466,"pcpadd":"18877 JEB STUART HWY","pcpcity":"STUART","pcpstate":"VA","pcpzip":241711019,"pcpcounty":"PATRICK","pcpid":"P0123924","pcpname":"PIONEER HEALTH SERVICES OF PATRICK COUNTY","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1433 CREASEY CHAPEL RD  ","madd2":"","madd3":"","mcity":"STUART","mstate":"VA","mzip":"24171-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["F41.1","R51","R42","K21.9","F41.9","K86.81","K58.0","S30.861D","J45.52","L85.9","R21","M81.8","Z78.0","J45.40","J30.81","J30.89","G43.019","M79.2","G89.29","R41.3","G56.03","S13.4XXS","F44.5","H81.391","K58.9","R19.7","Z12.31","N20.0","J45.30","G43.109","H90.3","G43.119","F33.1","J45.909","T78.40XA","Z78.9","R91.8","Z20.822","M25.551","Z79.899","F43.12","R73.03","F06.30","M79.7","M79.18","E66.9"],"date":["2021-10-22","2020-07-15","2020-07-15","2021-10-14","2021-10-27","2020-09-21","2020-09-21","2020-09-04","2020-09-04","2020-09-21","2020-09-21","2020-09-21","2020-09-21","2021-03-23","2021-03-23","2021-03-23","2020-11-04","2020-11-04","2021-07-21","2021-07-21","2021-02-03","2020-09-30","2021-06-23","2021-07-21","2021-10-27","2020-11-18","2020-11-18","2020-12-03","2020-12-03","2021-10-14","2021-01-07","2021-07-21","2021-04-21","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-03-17","2021-05-15","2021-08-06","2021-08-06","2021-10-14","2021-10-14","2021-10-14","2021-10-14","2021-10-14"],"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":[["","43547028111","ESCITALOPRAM","TAB 10MG","","Select","Select",""],["","29300011616","TOPIRAMATE","TAB 50MG","","Select","Select",""],["","33342008841","RIZATRIPTAN","TAB 10MG","","Select","Select",""],["","456111030","VIIBRYD","TAB 10MG","","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","","Select","Select",""],["","378054101","CIMETIDINE","TAB 800MG","","Select","Select",""],["","527058601","DICYCLOMINE","CAP 10MG","","Select","Select",""],["","172572970","FAMOTIDINE","TAB 40MG","","Select","Select",""],["","603548221","PROPRANOLOL","TAB 10MG","","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","","Select","Select",""],["","121081016","NYSTATIN","SUS 100000","","Select","Select",""],["","32301628","CREON","CAP 36000UNT","","Select","Select",""],["","49502050002","EPIPEN 2-PAK","INJ 0.3MG","","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","904600761","LORAZEPAM","TAB 0.5MG","","Select","Select",""],["","59762026003","COLESTIPOL","GRA 5GM","","Select","Select",""],["","16714008110","HYDROXYZ HCL","TAB 10MG","","Select","Select",""],["","832105415","BACLOFEN","TAB 10MG","","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","310737220","BUDES\/FORMOT","AER 80-4.5","","Select","Select",""],["","228202750","ALPRAZOLAM","TAB 0.25MG","","Select","Select",""],["","54327099","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","63402091164","BROVANA","NEB 15MCG","","Select","Select",""],["","487960130","BUDESONIDE","SUS 0.25MG\/2","","Select","Select",""],["","574010770","CLOTRIMAZOLE","TRO 10MG","","Select","Select",""],["","59746012206","MECLIZINE","TAB 12.5MG","","Select","Select",""],["","63304069205","CLINDAMYCIN","CAP 150MG","","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","93317431","ALBUTEROL SUL","FAT E","","Select","Select",""],["","603548221","PROPRANOLOL ","TAB 10MG","60","Select","Select",""],["","69097084507","CYCLOBENZAPR ","TAB 5MG","90","Select","Select",""],["","832105415","BACLOFEN ","TAB 10MG","90","Select","Select",""],["","378054101","CIMETIDINE ","TAB 800MG","60","Select","Select",""],["","456111030","VIIBRYD ","TAB 10MG","30","Select","Select",""],["","29300011616","TOPIRAMATE ","TAB 50MG","60","Select","Select",""],["","33342008841","RIZATRIPTAN ","TAB 10MG","12","Select","Select",""],["","43547028111","ESCITALOPRAM ","TAB 10MG","30","Select","Select",""],["","527058601","DICYCLOMINE ","CAP 10MG","120","Select","Select",""],["","29300022019","MONTELUKAST ","TAB 10MG","30","Select","Select",""],["","59762026003","COLESTIPOL ","GRA 5GM","500","Select","Select",""],["","172572970","FAMOTIDINE ","TAB 40MG","60","Select","Select",""],["","55111014512","FLUCONAZOLE ","TAB 150MG","3","Select","Select",""],["","69315090401","LORAZEPAM ","TAB 0.5MG","90","Select","Select",""],["","121081016","NYSTATIN ","SUS 100000","100","Select","Select",""],["","49502050002","EPIPEN ","INJ 0.3MG","2","Select","Select",""],["","50111078751","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","487960130","BUDESONIDE ","SUS 0.25MG\/2","60","Select","Select",""],["","32301628","CREON ","CAP 36000UNT","90","Select","Select",""],["","63402091164","BROVANA ","NEB 15MCG","120","Select","Select",""],["","59746012206","MECLIZINE ","TAB 12.5MG","60","Select","Select",""],["","16714008110","HYDROXYZ ","TAB 10MG","90","Select","Select",""],["","93317431","ALBUTEROL ","FAT E","8.5","Select","Select",""],["","31722071390","PANTOPRAZOLE ","TAB 40MG","30","Select","Select",""],["","54327099","FLUTICASONE ","SPR 50MCG","16","Select","Select",""],["","228202750","ALPRAZOLAM ","TAB 0.25MG","20","Select","Select",""],["","310737220","BUDES\/FORMOT ","AER 80-4.5","10.2","Select","Select",""],["","63304069205","CLINDAMYCIN ","CAP 150MG","28","Select","Select",""],["","63402030230","LATUDA ","TAB 20MG","30","Select","Select",""],["","574010770","CLOTRIMAZOLE ","10MG","70","Select","Select",""],["","49502050002","EPIPEN","0.3MG","2","Select","Select",""],["","17772010330","TROKENDI","100MG","30","Select","Select",""],["","16714008110","HYDROXYZ","10MG","90","Select","Select",""],["","64764073030","TRINTELLIX","10MG","30","Select","Select",""],["","69097016887","ARFORMOTEROL","15\/2ML","120","Select","Select",""],["","68180096301","ALBUTEROL","HFA","8.5","Select","Select",""],["","00093083201","CLONAZEPAM","0.5MG","90","Select","Select",""],["","63402030230","LATUDA","20MG","30","Select","Select",""],["","63402019030","LUNESTA","1MG","30","Select","Select",""],["","00093005301","BUSPIRONE","5MG","60","Select","Select",""],["","64764073030","TRINTELLIX ","TAB 10MG","30","Select","Select",""],["","00093005301","BUSPIRONE ","TAB 5MG","90","Select","Select",""],["","17772010330","TROKENDI ","CAP 100MG","30","Select","Select",""],["","63402019030","LUNESTA ","TAB 1MG","30","Select","Select",""],["","00093083201","CLONAZEPAM ","TAB 0.5MG","90","Select","Select",""],["","69097016887","ARFORMOTEROL ","NEB 15\/2ML","120","Select","Select",""],["","72205001290","PREGABALIN ","CAP 50MG","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":[[["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":""}]}]}