{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDSAY G HOKE","gend":0,"add":"5132 KANAWHA TRAIL","city":"COVINGTON","state":"VA","zip":"24426-7714","dob":"1946-11-29","age":"","mstatus":"","insh":11015993,"cliId":"9DR8PV5KE25","pno":5405594118,"cno":5405594118,"email":"","ename":"","eno":"","pphy":"MONROE, JULIE A","ppno":5404633381,"pcpadd":"55 Comfort Way,Ste 1","pcpcity":"Lexington","pcpstate":"VA","pcpzip":244503788,"pcpcounty":"","pcpid":"P9443176","pcpname":"BATH COMMUNITY PHYSICIANS GROUP","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"5132 KANAWHA TRAIL","madd2":"","madd3":"","mcity":"COVINGTON","mstate":"VA","mzip":"24426-7714","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["I25.89","E78.5","I10","E03.9","E11.9","Z23","M25.561","M54.5","M12.9","M17.11","M05.9","I48.92","I48.0","I47.1","I25.10","I35.0","Z95.2","Z95.1","G47.33","I65.23","J98.4","I48.91","I51.7","R06.00","R06.09","R05","R00.0","M79.89","I50.9","G47.31","J44.9","M25.562","Z79.899","E11.40","Z79.891","E11.3593","Z96.1","Z79.4","W19.XXXA","R09.02","G47.30","M54.2","E66.9","N18.30","D64.9","Z12.5","N18.3","R06.02","R09.81","R05.9","K80.20","R25.1","R79.1"],"date":["2021-11-01","2021-09-28","2021-09-28","2021-09-28","2021-09-28","2020-09-23","2020-09-23","2021-08-10","2021-08-10","2021-08-10","2020-10-06","2021-05-26","2021-08-25","2021-08-25","2020-11-25","2020-11-25","2021-08-25","2021-08-25","2021-08-25","2021-08-25","2021-08-25","2020-12-23","2021-01-13","2021-11-26","2021-11-18","2021-01-13","2021-01-13","2021-01-13","2021-09-20","2021-02-28","2021-02-28","2021-02-02","2021-06-03","2020-12-01","2021-02-02","2021-09-20","2021-03-22","2021-09-20","2021-03-23","2021-09-28","2021-09-28","2021-08-10","2021-08-25","2021-05-26","2021-06-28","2021-06-28","2021-08-25","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-03","2021-11-22"],"priorHcc":[null,"","","","","","","","","","","","","","","","","","","","","","",null,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":[["","51991070505","ALPRAZOLAM","TAB 0.5MG","","Select","Select",""],["","43386035701","HYDROCO\/APAP","TAB 7.5-325","","Select","Select",""],["","8290328438","INSULIN SYRG","MIS 0.3\/31G","","Select","Select",""],["","310654004","BYDUREON BC","INJ 2\/0.85ML","","Select","Select",""],["","378021610","FUROSEMIDE","TAB 40MG","","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","69547035302","NARCAN","SPR ","","Select","Select",""],["","93317431","ALBUTEROL SUL","FAT E","","Select","Select",""],["","57664047758","METOPROL TAR","TAB 50MG","","Select","Select",""],["","169183711","NOVOLIN","INJ 70\/30","","Select","Select",""],["","2871501","HUMULIN","INJ 70\/30","","Select","Select",""],["","3089421","ELIQUIS","TAB 5MG","","Select","Select",""],["","378181377","LEVOTHYROXIN","TAB 125MCG","","Select","Select",""],["","57237001401","TAMSULOSIN","CAP 0.4MG","","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","","Select","Select",""],["","69097081507","GABAPENTIN","CAP 400MG","","Select","Select",""],["","69097083512","SERTRALINE","TAB 100MG","","Select","Select",""],["","88221905","LANTUS SOLOS","INJ 100\/ML","","Select","Select",""],["","59310057922","PROAIR HFA","AER ","","Select","Select",""],["","597008717","ATROVENT HFA","AER 17MCG","","Select","Select",""],["","51991070505","ALPRAZOLAM ","TAB 0.5MG","60","Select","Select",""],["","8290328438","INSULIN ","MIS 0.3\/31G","200","Select","Select",""],["","3089421","ELIQUIS ","TAB 5MG","60","Select","Select",""],["","57664047758","METOPROL ","TAB 50MG","90","Select","Select",""],["","378021610","FUROSEMIDE ","TAB 40MG","90","Select","Select",""],["","93317431","ALBUTEROL ","FAT E","34","Select","Select",""],["","57237001401","TAMSULOSIN ","CAP 0.4MG","90","Select","Select",""],["","597008717","ATROVENT ","AER 17MCG","38.7","Select","Select",""],["","310654004","BYDUREON ","INJ 2\/0.85ML","10.2","Select","Select",""],["","43386035701","HYDROCO\/APAP ","TAB 7.5-325","120","Select","Select",""],["","53885027210","ONETOUCH ","TES VERIO","300","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","Select","Select",""],["","88221905","LANTUS ","INJ 100\/ML","90","Select","Select",""],["","59651000305","OMEPRAZOLE ","CAP 40MG","180","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","2871501","HUMULIN ","INJ 70\/30","40","Select","Select",""],["","169183711","NOVOLIN ","INJ 70\/30","40","Select","Select",""],["","69097081507","GABAPENTIN ","CAP 400MG","90","Select","Select",""],["","378181377","LEVOTHYROXIN ","TAB 125MCG","90","Select","Select",""],["","2143380","TRULICITY ","INJ 0.75\/0.5","2","Select","Select",""],["","69097083512","SERTRALINE ","100MG","135","Select","Select",""],["","08290324909","INSULIN","0.3\/31G","200","Select","Select",""],["","57664016758","METOPROL","100MG","180","Select","Select",""],["","00093317431","ALBUTEROL","E","8.5","Select","Select",""],["","00597008717","ATROVENT","17MCG","38.7","Select","Select",""],["","00310654004","BYDUREON","2\/0.85ML","10.2","Select","Select",""],["","59310057922","PROAIR","","8.5","Select","Select",""],["","00088221905","LANTUS","100\/ML","90","Select","Select",""],["","00002143380","TRULICITY","0.75\/0.5","2","Select","Select",""],["","08290320119","BD PEN NEEDL","31GX5MM","100","Select","Select",""],["","65862050320","AMOX\/K","875-125","20","Select","Select",""],["","65862050320","AMOX\/K ","TAB 875-125","20","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","51862085601","CARB\/LEVO ","TAB 25-100MG","90","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":""}]}]}