{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBRA J BARTNICKI","gend":1,"add":"50 LAMBERT SPRINGS RD","city":"KENBRIDGE","state":"VA","zip":"23944-9998","dob":"1959-04-29","age":"","mstatus":"","insh":11017286,"cliId":"1KJ1UC6MM25","pno":4342623631,"cno":4342623631,"email":"","ename":"","eno":"","pphy":"MICHIE, DAVID W","ppno":4345842000,"pcpadd":"200 E 5th St","pcpcity":"Chase City  ","pcpstate":"VA","pcpzip":239241456,"pcpcounty":"Mecklenburg","pcpid":"P0060193","pcpname":"KENBRIDGE FAMILY MEDICINE","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"50 LAMBERT SPRINGS RD","madd2":"","madd3":"","mcity":"KENBRIDGE","mstate":"VA","mzip":"23944-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Current Conditions \/ Suspect Codes","q":[{"a":{"diag":["R21","I65.23","M48.02","G95.20","G99.2","G81.94","E78.5","I73.9","I25.10","J44.9","R29.704","M54.12","F12.10","D50.9","E03.9","G89.29","Z20.822","R32","F17.210","M79.609","R20.0","R51.9","R20.2","R20.8","R53.1","M79.662","I11.0","K21.9","Z95.1","Z04.9","M50.01","R26.2","R10.9","I10","I95.9","G89.18","L90.5","R03.0","R26.9","N31.9","M47.812","M50.31","M50.322","M50.323","M25.78","M50.20","G95.89","Z47.89","M17.12","M54.10","F32.2","I77.4","I25.2","G89.4","F11.20","M54.2","Z98.890","X50.1XXA","S16.1XXA","X58.XXXA","R41.82","I70.203","E87.6","E83.42","R73.9","R41.0","F19.11","Z87.898","R45.1","I11.9","R82.5","M54.9","Z79.891","F30.9","S69.91XA","S19.9XXA","S09.90XA","Z98.1","S49.91XA","S52.521A","M18.11","M79.89","S52.591A","W01.0XXA","W19.XXXA","Y92.89","S89.92XA","S52.501A"],"date":["2021-01-18","2021-01-19","2021-05-24","2021-02-06","2021-01-19","2021-01-23","2021-08-25","2021-02-06","2021-08-27","2021-08-26","2021-01-19","2021-07-05","2021-08-25","2021-08-26","2021-02-06","2021-09-01","2021-08-25","2021-01-19","2021-08-27","2021-01-19","2021-02-25","2021-01-21","2021-02-25","2021-01-19","2021-01-25","2021-01-20","2021-01-22","2021-08-25","2021-08-27","2021-01-19","2021-01-23","2021-01-23","2021-01-23","2021-08-25","2021-01-22","2021-01-23","2021-01-23","2021-01-23","2021-01-25","2021-01-25","2021-01-28","2021-07-05","2021-01-28","2021-01-28","2021-01-30","2021-05-13","2021-01-30","2021-02-06","2021-09-02","2021-02-06","2021-02-06","2021-02-06","2021-08-25","2021-06-23","2021-05-13","2021-09-01","2021-05-19","2021-05-19","2021-07-05","2021-07-05","2021-08-27","2021-08-25","2021-09-01","2021-08-27","2021-08-27","2021-08-26","2021-08-26","2021-08-26","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-08-27","2021-09-01","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-02","2021-09-10"],"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":[["","53746010905","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","378064210","PREDNISONE","TAB 20MG","","Select","Select",""],["","70010077005","METHOCARBAM","TAB 750MG","","Select","Select",""],["","69547035302","NARCAN","SPR ","","Select","Select",""],["","172392560","DIAZEPAM","TAB 2MG","","Select","Select",""],["","406055201","OXYCODONE","TAB 5MG","","Select","Select",""],["","69238131309","PREGABALIN","CAP 100MG","","Select","Select",""],["","378003210","METOPROL TAR","TAB 50MG","","Select","Select",""],["","60505267108","ATORVASTATIN","TAB 80MG","","Select","Select",""],["","378668999","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","115180301","HYDROXYZ PAM","CAP 25MG","","Select","Select",""],["","591079501","DICYCLOMINE","TAB 20MG","","Select","Select",""],["","65862052890","VENLAFAXINE","CAP 75MG ER","","Select","Select",""],["","49884072703","DOXYCYC MONO","CAP 100MG","","Select","Select",""],["","51991031190","DESVENLAFAX","TAB 50MG ER","","Select","Select",""],["","69097084607","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","68180096803","LEVOTHYROXIN","TAB 88MCG","","Select","Select",""],["","53746010905","HYDROCO\/APAP ","TAB 5-325MG","42","Select","Select",""],["","378064210","PREDNISONE ","TAB 20MG","7","Select","Select",""],["","69238131309","PREGABALIN ","CAP 100MG","60","Select","Select",""],["","591079501","DICYCLOMINE ","TAB 20MG","120","Select","Select",""],["","60505267108","ATORVASTATIN ","TAB 80MG","90","Select","Select",""],["","70010077005","METHOCARBAM ","TAB 750MG","80","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","406055201","OXYCODONE ","TAB 5MG","42","Select","Select",""],["","172392560","DIAZEPAM ","TAB 2MG","21","Select","Select",""],["","378003210","METOPROL ","TAB 50MG","180","Select","Select",""],["","115180301","HYDROXYZ ","CAP 25MG","60","Select","Select",""],["","378668999","PANTOPRAZOLE ","TAB 40MG","90","Select","Select",""],["","68180096803","LEVOTHYROXIN ","TAB 88MCG","90","Select","Select",""],["","69097084607","CYCLOBENZAPR ","TAB 10MG","60","Select","Select",""],["","65862052890","VENLAFAXINE ","CAP 75MG ER","90","Select","Select",""],["","68462015713","ONDANSETRON ","4MG ODT","90","Select","Select",""],["","172409680","BACLOFEN ","10MG","30","Select","Select",""],["","65162062711","TRAMADOL ","50MG","12","Select","Select",""],["","51991031190","DESVENLAFAX ","50MG ER","30","Select","Select",""],["","49884072703","DOXYCYC ","100MG","14","Select","Select",""],["","00378003210","METOPROL","50MG","180","Select","Select",""],["","68462015713","ONDANSETRON","4MG ODT","90","Select","Select",""],["","65162062711","TRAMADOL","50MG","12","Select","Select",""],["","00115180301","HYDROXYZ","25MG","60","Select","Select",""],["","49884072703","DOXYCYC","100MG","14","Select","Select",""],["","00172409680","BACLOFEN","10MG","30","Select","Select",""],["","59762330403","NITROGLYCERN","0.4MG","25","Select","Select",""],["","69097052444","DICLOFENAC","1%","100","Select","Select",""],["","59762330403","NITROGLYCERN ","SUB 0.4MG","25","Select","Select",""],["","57664050218","TIZANIDINE ","TAB 2MG","60","Select","Select",""],["","69097052444","DICLOFENAC ","GEL 0.01","100","Select","Select",""],["","59746000103","METHYLPRED ","TAB 4MG","21","Select","Select",""],["","33342015715","CELECOXIB ","CAP 200MG","30","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":""}]}]}