{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"COAGLE GRAVLEY","gend":0,"add":"1197 POWERS PLACE ","city":"PULASKI  ","state":"VA","zip":"24301-9998","dob":"1954-11-21","age":"","mstatus":"","insh":11014782,"cliId":"2F84JW6QP50","pno":5406291451,"cno":5406291451,"email":"","ename":"","eno":"","pphy":"STEWART, KNOTRESHA F ","ppno":5408350500,"pcpadd":"28 Town Center Dr","pcpcity":"Dublin","pcpstate":"VA","pcpzip":240846069,"pcpcounty":"","pcpid":"P0124296","pcpname":"RIVER VALLEY HEALTHCARE ASSOCIATES PC","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"1197 POWERS PLACE ","madd2":"","madd3":"","mcity":"PULASKI  ","mstate":"VA","mzip":"24301-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["M51.16","G89.4","R63.4","G25.2","M19.049","Z11.4","Z13.220","Z12.5","F17.200","Z13.6","Z11.59","F33.2","Z23","D75.89","J44.9","F41.9","Z79.891","M96.1","M54.5","G89.29","M51.36","Z51.81","M54.16","M19.90","M54.50"],"date":["2021-05-11","2021-11-23","2020-11-03","2020-11-03","2020-12-01","2020-11-03","2020-11-03","2020-11-03","2020-11-03","2020-11-03","2020-11-03","2020-11-03","2020-12-01","2020-12-02","2020-12-01","2020-12-01","2021-11-23","2021-03-12","2021-09-28","2021-05-11","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23"],"priorHcc":["",null,"","","","","","","","","","","","","","",null,"","","",null,null,null,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":[["","603548232","PROPRANOLOL","TAB 10MG","","Select","Select",""],["","16714073201","CELECOXIB","CAP 100MG","","Select","Select",""],["","93005301","BUSPIRONE","TAB 5MG","","Select","Select",""],["","65862019201","FLUOXETINE","CAP 10MG","","Select","Select",""],["","71093011105","GABAPENTIN","TAB 600MG","","Select","Select",""],["","406052301","OXYCOD\/APAP","TAB 10-325MG","","Select","Select",""],["","68462025501","ROPINIROLE","TAB 1MG","","Select","Select",""],["","13107003105","MIRTAZAPINE","TAB 15MG","","Select","Select",""],["","173086910","ANORO ELLIPT","AER 62.5-25","","Select","Select",""],["","603548232","PROPRANOLOL ","TAB 10MG","60","Select","Select",""],["","13107003105","MIRTAZAPINE ","TAB 15MG","90","Select","Select",""],["","16714073201","CELECOXIB ","CAP 100MG","30","Select","Select",""],["","65862019201","FLUOXETINE ","CAP 10MG","30","Select","Select",""],["","173086910","ANORO ","AER 62.5-25","60","Select","Select",""],["","93005301","BUSPIRONE ","TAB 5MG","60","Select","Select",""],["","71093011105","GABAPENTIN ","TAB 600MG","120","Select","Select",""],["","406052301","OXYCOD\/APAP ","TAB 10-325MG","120","Select","Select",""],["","68462025501","ROPINIROLE ","TAB 1MG","30","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","16571020210","DICLOFENAC ","50MG DR","60","Select","Select",""],["","16571020210","DICLOFENAC","50MG DR","60","Select","Select",""],["","69547035302","NARCAN","","2","Select","Select",""],["","00173086910","ANORO","62.5-25","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","",""],["Yes","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":""}]}]}