{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PHYLLIS A WALKER","gend":1,"add":"847 GARRETT ROAD  ","city":"RIDGEWAY ","state":"VA","zip":"24148-9998","dob":"1953-08-21","age":"","mstatus":"","insh":11015558,"cliId":"6W45P79FP83","pno":2769561099,"cno":2762523752,"email":"","ename":"","eno":"","pphy":"OH PARK, ANGELA J ","ppno":2769562047,"pcpadd":"6460 Greensboro Rd","pcpcity":"Ridgeway ","pcpstate":"VA","pcpzip":241483478,"pcpcounty":"","pcpid":"P9443268","pcpname":"PARK MD CHAN M FAMILY PRACTICE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APT F","add3":"","madd1":"847 GARRETT ROAD  ","madd2":"APT F","madd3":"","mcity":"RIDGEWAY ","mstate":"VA","mzip":"24148-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["Z79.899","I10","Z71.89","Z71.3","Z86.79","M25.879","Z01.818","Z23","M20.41","G89.18","Y83.1","M20.11","M21.611","T84.84XA","J44.9","K21.9","F17.210","Z99.81","Z79.82","T84.9XXA","M13.871","M24.574","M25.571","R60.0","M79.671","J45.51","I42.9","Z71.6","Z20.828","M20.40","H02.885","H02.882","H04.123","H26.499","H52.4","H17.13","H26.491","M79.661","Z12.31","G60.3","M79.604","I42.0","F17.200","Z12.2","I50.89","I34.8","R05","M79.605","Z87.891","R63.4","H10.9","H57.89","H57.13","H10.45","H20.00"],"date":["2021-11-05","2021-08-10","2021-06-08","2021-06-08","2020-10-16","2020-10-08","2020-10-12","2020-10-08","2021-01-20","2020-10-16","2020-10-16","2021-01-20","2020-12-15","2020-10-16","2021-09-10","2020-10-16","2021-09-10","2020-10-16","2020-10-16","2020-10-16","2021-03-17","2020-12-15","2021-08-20","2021-01-20","2021-03-17","2021-09-10","2021-09-10","2021-09-10","2021-01-30","2021-03-17","2021-04-29","2021-04-29","2021-11-10","2021-04-29","2021-04-29","2021-05-13","2021-05-13","2021-06-04","2021-06-21","2021-08-20","2021-07-09","2021-07-07","2021-08-04","2021-08-04","2021-08-10","2021-08-10","2021-09-10","2021-07-09","2021-06-08","2021-06-08","2021-10-08","2021-10-08","2021-10-08","2021-10-22","2021-11-10"],"priorHcc":[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":[["","51224012230","AZITHROMYCIN","TAB 500MG","","Select","Select",""],["","173088710","TRELEGY","AER ELLIPTA","","Select","Select",""],["","406012305","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","93031401","KETOROLAC","TAB 10MG","","Select","Select",""],["","955100410","ENOXAPARIN","INJ 40\/0.4ML","","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","","Select","Select",""],["","53489012002","DOXYCYCL HYC","TAB 100MG","","Select","Select",""],["","68645055254","LISINOPRIL","TAB 10MG","","Select","Select",""],["","49884072703","DOXYCYC MONO","CAP 100MG","","Select","Select",""],["","10702005601","OXYCODONE","TAB 10MG","","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","60505082901","FLUTICASONE ","SPR 50MCG","48","Select","Select",""],["","173088710","TRELEGY ","AER ELLIPTA","60","Select","Select",""],["","51224012230","AZITHROMYCIN ","TAB 500MG","15","Select","Select",""],["","61314063006","NEO\/POLY\/DEX ","SUS 0.1% OP","5","Select","Select",""],["","23916330","RESTASIS ","EMU 0.0005","60","Select","Select",""],["","406012305","HYDROCO\/APAP ","TAB 5-325MG","90","Select","Select",""],["","69097052444","DICLOFENAC ","GEL 0.01","200","Select","Select",""],["","93031401","KETOROLAC ","TAB 10MG","20","Select","Select",""],["","53489012002","DOXYCYCL ","TAB 100MG","14","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","Select","Select",""],["","68645055254","LISINOPRIL ","TAB 10MG","90","Select","Select",""],["","68462010530","ONDANSETRON ","TAB 4MG","20","Select","Select",""],["","955100410","ENOXAPARIN ","INJ 40\/0.4ML","0.8","Select","Select",""],["","43598029190","PREGABALIN ","25MG","28","Select","Select",""],["","378967130","IPRATROPIUM\/ ","ALBUTER","360","Select","Select",""],["","68180072003","AMLODIPINE ","5MG","90","Select","Select",""],["","49884072703","DOXYCYC ","100MG","10","Select","Select",""],["","10702005601","OXYCODONE ","10MG","40","Select","Select",""],["","31722071390","PANTOPRAZOLE ","40MG","30","Select","Select",""],["","69547035302","NARCAN ","","2","Select","Select",""],["","43598029190","PREGABALIN","25MG","28","Select","Select",""],["","00378967130","IPRATROPIUM\/","ALBUTER","360","Select","Select",""],["","69097052444","DICLOFENAC","0.01","200","Select","Select",""],["","61314063006","NEO\/POLY\/DEX","0.1% OP","5","Select","Select",""],["","00023916330","RESTASIS","0.0005","60","Select","Select",""],["","00093092610","LOVASTATIN","10MG","90","Select","Select",""],["","69547035302","NARCAN","","2","Select","Select",""],["","68180072003","AMLODIPINE","5MG","90","Select","Select",""],["","53489012002","DOXYCYCL","100MG","14","Select","Select",""],["","59310057922","PROAIR","","8.5","Select","Select",""],["","49884072703","DOXYCYC","100MG","10","Select","Select",""],["","00378064110","PREDNISONE","10MG","20","Select","Select",""],["","68180096301","ALBUTEROL","HFA","8.5","Select","Select",""],["","61314062810","POLYMYXIN","TRIMETHP","10","Select","Select",""],["","61314063705","PREDNISOLONE","1% OP","5","Select","Select",""],["","61314062810","POLYMYXIN ","SOL TRIMETHP","10","Select","Select",""],["","00093092610","LOVASTATIN ","TAB 10MG","90","Select","Select",""],["","61314063705","PREDNISOLONE ","SUS 1% OP","10","Select","Select",""],["","70069000701","OLOPATADINE ","DRO 0.001","5","Select","Select",""],["","70461012103","FLUAD ","INJ 2021-22","0.5","Select","Select",""],["","00378064110","PREDNISONE ","TAB 10MG","20","Select","Select",""],["","68180096301","ALBUTEROL ","AER HFA","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":[[["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":""}]}]}