{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VANESSA M HOWELL","gend":1,"add":"15A Longview Dr Apt 15A ","city":"Wytheville  ","state":"VA","zip":"24382-4046","dob":"1974-03-05","age":"","mstatus":"","insh":11018389,"cliId":"5KT2F40MP84","pno":2763894179,"cno":2763894179,"email":"","ename":"","eno":"","pphy":"TURSKI III, JOHN T","ppno":2766884331,"pcpadd":"600 W Ridge Rd","pcpcity":"Wytheville  ","pcpstate":"VA","pcpzip":243821044,"pcpcounty":"","pcpid":"P0060342","pcpname":"WYTHE FAMILY CARE CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"APT 15A","add3":"","madd1":"15A Longview Dr Apt 15A ","madd2":"APT 15A","madd3":"","mcity":"Wytheville  ","mstate":"VA","mzip":"24382-4046","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","E34.0","F41.0","F41.9","Z20.828","J09.X2","R92.8"],"date":["2021-07-09","2021-07-09","2021-07-09","2021-07-09","2021-08-13","2021-11-30","2021-10-06"],"priorHcc":["","","","","",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":[]},{"a":[]}]},{"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":[["","69238111701","BUSPIRONE ","10MG","90","Select","Select",""],["","27808003502","HYDROCO\/APAP ","5-325MG","90","Select","Select",""],["","33342008845","RIZATRIPTAN","10MG","10","Select","Select",""],["","27808003502","HYDROCO\/APAP","5-325MG","90","Select","Select",""],["","10702000350","PROMETHAZINE","25MG","25","Select","Select",""],["","69238111701","BUSPIRONE","10MG","90","Select","Select",""],["","64764017530","DEXILANT","60MG DR","30","Select","Select",""],["","52817033200","CYCLOBENZAPR","10MG","90","Select","Select",""],["","00781808926","AZITHROMYCIN","250MG","6","Select","Select",""],["","57237000830","MIRTAZAPINE","15MG","30","Select","Select",""],["","60758088010","FLUOROMETHOL","0.1% OP","10","Select","Select",""],["","33342008845","RIZATRIPTAN ","TAB 10MG","10","Select","Select",""],["","00781808926","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","68382004110","PROMETHAZINE ","TAB 25MG","25","Select","Select",""],["","64764017530","DEXILANT ","CAP 60MG DR","30","Select","Select",""],["","60758088010","FLUOROMETHOL ","SUS 0.1% OP","10","Select","Select",""],["","52817033200","CYCLOBENZAPR ","TAB 10MG","90","Select","Select",""],["","53489014305","SPIRONOLACT ","TAB 25MG","270","Select","Select",""],["","45802006405","TRIAMCINOLON ","CRE 0.001","454","Select","Select",""],["","57237000830","MIRTAZAPINE ","TAB 15MG","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","",""],["No","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":""}]}]}