{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMES S HIGGINS SR","gend":0,"add":"7301 SPRINGWOOD RD","city":"BUCHANAN ","state":"VA","zip":"24066-9998","dob":"1946-11-12","age":"","mstatus":"","insh":11013838,"cliId":"7D47XQ9QG38","pno":5407612423,"cno":5407612423,"email":"","ename":"","eno":"","pphy":"GLENNEY, ROBERT","ppno":5402541239,"pcpadd":"18080 Main St","pcpcity":"Buchanan ","pcpstate":"VA","pcpzip":240665482,"pcpcounty":"","pcpid":"P0117377","pcpname":"CARILION FAMILY MEDICINE BUCHANAN","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"7301 SPRINGWOOD RD","madd2":"","madd3":"","mcity":"BUCHANAN ","mstate":"VA","mzip":"24066-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["E11.9","I10","I50.32","L30.9","Z00.00","Z12.11","R73.9","R68.2","Z91.19","Z76.0","J20.9","J30.9","R05"],"date":["2021-08-05","2021-05-25","2021-05-25","2021-04-21","2021-04-21","2021-04-21","2020-10-29","2020-10-29","2020-11-20","2021-05-25","2021-07-29","2021-07-19","2021-07-19"],"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":[["","69097015807","MELOXICAM","TAB 7.5MG","","Select","Select",""],["","56151146004","TRUE METRIX","TES GLUCOSE","","Select","Select",""],["","591046010","GLIPIZIDE","TAB 5MG","","Select","Select",""],["","68180072103","AMLODIPINE","TAB 10MG","","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","68382075810","METFORMIN","TAB 500MG","","Select","Select",""],["","76385011250","CARVEDILOL","TAB 12.5MG","","Select","Select",""],["","65162044210","MECLIZINE","TAB 25MG","","Select","Select",""],["","49281072010","FLUBLOK QUAD","INJ 2020-21","","Select","Select",""],["","56151014260","TRUPLUS LANC","MIS 28G","","Select","Select",""],["","69097015807","MELOXICAM ","TAB 7.5MG","30","Select","Select",""],["","65162044210","MECLIZINE ","TAB 25MG","30","Select","Select",""],["","56151147002","TRUE ","KIT METER","1","Select","Select",""],["","56151014260","TRUPLUS ","MIS 28G","100","Select","Select",""],["","65862000899","METFORMIN ","TAB 500MG","60","Select","Select",""],["","591046010","GLIPIZIDE ","TAB 5MG","60","Select","Select",""],["","68180072103","AMLODIPINE ","TAB 10MG","90","Select","Select",""],["","76385011250","CARVEDILOL ","TAB 12.5MG","180","Select","Select",""],["","62175061743","PANTOPRAZOLE ","TAB 40MG","30","Select","Select",""],["","93727198","PIOGLITAZONE ","TAB 15MG","90","Select","Select",""],["","51672127401","BETAMETH ","CRE 0.0005","30","Select","Select",""],["","68180098003","LISINOPRIL ","TAB 10MG","90","Select","Select",""],["","49281072010","FLUBLOK ","INJ 2020-21","0.5","Select","Select",""],["","56151147002","TRUE","METER","1","Select","Select",""],["","56151014260","TRUPLUS","28G","100","Select","Select",""],["","00093727298","PIOGLITAZONE","30MG","90","Select","Select",""],["","68180098003","LISINOPRIL","10MG","90","Select","Select",""],["","00378064205","PREDNISONE","20MG","5","Select","Select",""],["","00093317431","ALBUTEROL","E","8.5","Select","Select",""],["","68180016013","AZITHROMYCIN","250MG","6","Select","Select",""],["","51672127401","BETAMETH","0.0005","30","Select","Select",""],["","49281072010","FLUBLOK","2020-21","0.5","Select","Select",""],["","00378064205","PREDNISONE ","TAB 20MG","5","Select","Select",""],["","68180016013","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","00093317431","ALBUTEROL ","FAT E","8.5","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","",""],["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":""}]}]}