{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATSY   C HIGGINS","gend":1,"add":"7301 SPRINGWOOD ROAD                                        ","city":"BUCHANAN                      ","state":"VA","zip":"24066-4787","dob":"1958-09-07","age":"","mstatus":"","insh":10055859,"cliId":"","pno":5404913473,"cno":5404913473,"email":"","ename":"","eno":"","pphy":"GLENNEY, ROBERT                                             ","ppno":"","pcpadd":"18080 Main St","pcpcity":"Buchanan                      ","pcpstate":"VA","pcpzip":240665482,"pcpcounty":"","pcpid":"P0117377","pcpname":"CARILION FAMILY MEDICINE BUCHANAN","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"7301 SPRINGWOOD ROAD                                        ","madd2":"                                                            ","madd3":"","mcity":"BUCHANAN                      ","mstate":"VA","mzip":"24066-4787","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E66.01","I10","R79.89","R07.89","G47.33","Z99.89","R07.9","R06.02","F41.8","I25.2","I44.0","I49.9","R16.0","N28.89","R93.2","R73.9","F41.9","K76.0","E11.69","E66.9","Z12.31","T50.905A","Z23","Z12.11","M54.5","G89.29","M47.816","Z76.0","M47.817","M51.36","L30.4","R94.31","E78.5","I35.1","I77.810","N39.0","R60.0","N32.89","Z79.82","Z79.84","Z79.899","N30.01","B96.89","R30.0","E11.9","I25.10","N13.2","R10.9","N20.0","N23","N20.1","Z79.891","R10.32","R11.10","N28.1","R11.2","Z20.822","R63.5","M25.561","I95.9","R42","I95.1","R19.7"],"date":["2021-07-01","2021-07-01","2020-11-20","2019-03-14","2021-06-16","2021-06-16","2019-03-09","2019-03-09","2019-03-08","2021-01-28","2019-03-09","2019-03-09","2019-03-13","2019-03-13","2019-03-13","2019-10-23","2019-03-14","2019-05-06","2021-07-01","2021-07-01","2019-05-28","2019-08-26","2021-04-21","2019-10-23","2021-07-01","2021-07-01","2019-11-26","2020-11-20","2019-12-10","2019-12-10","2019-12-19","2020-04-02","2020-04-02","2020-04-02","2020-04-02","2020-10-05","2020-09-21","2020-11-20","2021-01-28","2021-01-28","2020-09-21","2020-09-30","2020-09-30","2020-09-30","2021-01-28","2020-09-30","2020-10-02","2020-10-02","2020-10-21","2020-10-12","2020-10-22","2020-11-20","2021-01-28","2021-01-28","2021-01-28","2021-01-28","2021-01-28","2021-04-21","2021-04-21","2021-04-21","2021-07-01","2021-07-01","2021-08-09"],"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":[]},{"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":[["","67877021905","CEPHALEXIN","500MG","40","Select","Select",""],["","00193731025","CONTOUR","NEXT","25","Select","Select",""],["","00193658621","MICROLET","LANCETS","100","Select","Select",""],["","65162044210","MECLIZINE","25MG","90","Select","Select",""],["","69097015807","MELOXICAM","7.5MG","30","Select","Select",""],["","00591046010","GLIPIZIDE","5MG","90","Select","Select",""],["","00781540192","ROSUVASTATIN","10MG","30","Select","Select",""],["","43547035411","LISINOPRIL","20MG","30","Select","Select",""],["","59676058015","JANSSEN","COVID-19","0.5","Select","Select",""],["","00378773293","ONDANSETRON","4MG ODT","10","Select","Select",""],["","62756016013","TAMSULOSIN","0.4MG","30","Select","Select",""],["","53746010905","HYDROCO\/APAP","5-325MG","12","Select","Select",""],["","16571020210","DICLOFENAC","50MG DR","60","Select","Select",""],["","00378041510","DIPHEN\/ATROP","2.5MG","15","Select","Select",""],["","68180039601","CELECOXIB","100MG","60","Select","Select",""],["","43547034811","PAROXETINE","20MG","30","Select","Select",""],["","00536101801","TRAVEL","25MG","30","Select","Select",""],["","53746020305","OXYCOD\/APAP","5-325MG","20","Select","Select",""],["","69452015120","VITAMIN","50000UNT","4","Select","Select",""],["","00093727298","PIOGLITAZONE","30MG","30","Select","Select",""],["","66993001968","ALBUTEROL","HFA","18","Select","Select",""],["","69367016304","PHENAZOPYRID","200MG","9","Select","Select",""],["","47781030301","NITROFURANTN","100MG","14","Select","Select",""],["","00603497521","OXYBUTYNIN","5MG","60","Select","Select",""],["","00378020810","FUROSEMIDE","20MG","30","Select","Select",""],["","67877021905","CEPHALEXIN ","CAP 500MG","40","Select","Select",""],["","00193731025","CONTOUR ","TES NEXT","25","Select","Select",""],["","00193658621","MICROLET ","MIS LANCETS","100","Select","Select",""],["","65162044210","MECLIZINE ","TAB 25MG","90","Select","Select",""],["","69097015807","MELOXICAM ","TAB 7.5MG","30","Select","Select",""],["","00591046010","GLIPIZIDE ","TAB 5MG","90","Select","Select",""],["","00781540192","ROSUVASTATIN ","TAB 10MG","30","Select","Select",""],["","43547035411","LISINOPRIL ","TAB 20MG","30","Select","Select",""],["","59676058015","JANSSEN ","INJ COVID-19","0.5","Select","Select",""],["","00378773293","ONDANSETRON ","TAB 4MG ODT","10","Select","Select",""],["","62756016013","TAMSULOSIN ","CAP 0.4MG","30","Select","Select",""],["","53746010905","HYDROCO\/APAP ","TAB 5-325MG","12","Select","Select",""],["","16571020210","DICLOFENAC ","TAB 50MG DR","60","Select","Select",""],["","00378041510","DIPHEN\/ATROP ","TAB 2.5MG","15","Select","Select",""],["","68180039601","CELECOXIB ","CAP 100MG","60","Select","Select",""],["","43547034811","PAROXETINE ","TAB 20MG","30","Select","Select",""],["","00536101801","TRAVEL ","CHW 25MG","30","Select","Select",""],["","53746020305","OXYCOD\/APAP ","TAB 5-325MG","20","Select","Select",""],["","69452015120","VITAMIN ","CAP 50000UNT","4","Select","Select",""],["","00093727298","PIOGLITAZONE ","TAB 30MG","30","Select","Select",""],["","66993001968","ALBUTEROL ","AER HFA","18","Select","Select",""],["","69367016304","PHENAZOPYRID ","TAB 200MG","9","Select","Select",""],["","47781030301","NITROFURANTN ","CAP 100MG","14","Select","Select",""],["","00603497521","OXYBUTYNIN ","TAB 5MG","60","Select","Select",""],["","00378020810","FUROSEMIDE ","TAB 20MG","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":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","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":""}]}]}