{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TONYA   A MULLINS","gend":1,"add":"118 HESS STREET","city":"NARROWS","state":"VA","zip":"24124-1806","dob":"1974-03-27","age":"","mstatus":"","insh":10056872,"cliId":"","pno":5409227688,"cno":5409227688,"email":"","ename":"","eno":"","pphy":"LOUGH, ANDREA R","ppno":5409212829,"pcpadd":"1611 Wenonah Ave, ","pcpcity":"Pearisburg","pcpstate":"VA","pcpzip":241341839,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"118 HESS STREET","madd2":"                                                            ","madd3":"","mcity":"NARROWS","mstate":"VA","mzip":"24124-1806","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G89.4","Z79.899","M51.36","L93.0","F31.9","F41.1","M16.12","Z23","E11.69","D68.51","G47.30","Z12.31","E66.9","S83.209A","Z96.659","H91.90","H69.81","M26.609","Z86.69","G50.1","Z79.891","G89.29","M54.2","R51","M25.50","M51.26","M54.5","M54.12","M51.37","M50.30","M25.552","D68.62","R63.5","I10","J44.9","J30.89","E78.2","S73.192D","E66.01","Z68.41","X58.XXXD","G47.00","H02.63","H02.66","M79.89","R06.81","R06.83","R05","R51.9","G47.34","F17.210","Z99.81","G47.33","G47.10","Z68.42","F31.89","M65.312","M76.02","Z01.818","Z01.810","K21.9","E63.9","Z86.2","E55.9","Z87.19","R73.09","S73.192A","S76.012A","R63.1","R53.83","Z79.01","M53.3","L03.818","H69.90","R73.9","M16.11","M25.551","G47.36","R40.0","E11.9","Z86.711","Z86.718","J32.9","H90.0","Z72.0","E78.5"],"date":["2020-10-09","2021-04-27","2020-09-09","2019-09-16","2021-04-09","2021-04-09","2021-04-27","2020-10-09","2021-01-29","2020-10-09","2020-10-09","2020-10-09","2021-01-29","2021-03-29","2021-03-29","2019-05-01","2019-05-01","2019-05-01","2019-05-01","2019-05-01","2019-04-02","2021-01-27","2019-04-30","2019-04-30","2019-04-30","2019-04-30","2019-04-30","2019-04-30","2021-04-27","2019-04-30","2021-03-31","2020-09-09","2020-08-21","2021-01-29","2020-12-06","2020-08-21","2020-08-21","2020-07-28","2021-03-31","2021-03-31","2020-03-18","2021-03-03","2020-08-14","2020-08-14","2020-08-18","2020-11-16","2020-11-16","2020-11-16","2020-11-16","2020-11-16","2020-11-16","2020-11-16","2021-03-03","2020-12-07","2020-12-07","2020-12-07","2019-09-12","2019-10-02","2019-12-05","2019-12-05","2020-12-06","2019-12-05","2019-12-05","2019-12-05","2019-12-05","2019-12-05","2020-03-18","2020-03-26","2020-08-14","2020-08-14","2020-08-18","2020-09-08","2021-01-29","2019-05-01","2019-07-17","2020-08-05","2020-08-05","2020-12-06","2020-12-06","2020-12-06","2020-12-06","2020-12-06","2019-01-03","2019-01-22","2019-07-17","2019-07-17"],"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":[["","63402030230","LATUDA ","TAB 20MG","30","Select","Select",""],["","65862049001","QUETIAPINE ","TAB 50MG","120","Select","Select",""],["","51672403401","WARFARIN ","TAB 7.5MG","90","Select","Select",""],["","67253090250","ALPRAZOLAM ","TAB 1MG","1","Select","Select",""],["","61874011530","VRAYLAR ","CAP 1.5MG","30","Select","Select",""],["","65862020399","LOSARTAN ","TAB 100MG","30","Select","Select",""],["","68180071909","AMLODIPINE ","TAB 2.5MG","30","Select","Select",""],["","13668021930","ARIPIPRAZOLE ","TAB 15MG","30","Select","Select",""],["","16729018317","HYDROCHLOROT ","TAB 25MG","30","Select","Select",""],["","68382013905","TOPIRAMATE ","TAB 50MG","60","Select","Select",""],["","00115180301","HYDROXYZ ","CAP 25MG","60","Select","Select",""],["","43598081115","CETIRIZINE ","TAB 10MG","90","Select","Select",""],["","51672400501","CARBAMAZEPIN ","TAB 200MG","120","Select","Select",""],["","68382013201","TAMSULOSIN ","CAP 0.4MG","30","Select","Select",""],["","68462039610","OMEPRAZOLE ","CAP 20MG","30","Select","Select",""],["","64764073030","TRINTELLIX ","TAB 10MG","30","Select","Select",""],["","67877056105","METFORMIN ","TAB 500MG","58","Select","Select",""],["","68180031909","BUPROPN ","TAB 150MG XL","30","Select","Select",""],["","52817018110","CLONIDINE ","TAB 0.2MG","30","Select","Select",""],["","00093031401","KETOROLAC ","TAB 10MG","20","Select","Select",""],["","00597007541","SPIRIVA ","CAP HANDIHLR","30","Select","Select",""],["","00363089588","NICOTINE ","DIS 14MG\/24H","14","Select","Select",""],["","59762033302","LATANOPROST ","SOL 0.00005","2.5","Select","Select",""],["","00406851501","OXYCODONE ","TAB 15MG","120","Select","Select",""],["","68462080101","METHADONE ","TAB 10MG","90","Select","Select",""],["","55111025760","ZIPRASIDONE ","CAP 40MG","30","Select","Select",""],["","00093314705","CEPHALEXIN ","CAP 500MG","40","Select","Select",""],["","13668033005","TRAZODONE ","TAB 50MG","30","Select","Select",""],["","43547035410","LISINOPRIL ","TAB 20MG","90","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","63481016160","BELBUCA ","MIS 75MCG","60","Select","Select",""],["","65862001705","AMOXICILLIN ","CAP 500MG","4","Select","Select",""],["","24510011010","XTAMPZA ","CAP 9MG","60","Select","Select",""],["","00093227534","AMOX\/K ","TAB 875-125","20","Select","Select",""],["","70461041810","FLUCLVX ","INJ 2018-19","0.5","Select","Select",""],["","00093317431","ALBUTEROL ","FAT E","8.5","Select","Select",""],["","00193731221","CONTOUR ","TES NEXT","100","Select","Select",""],["","69238111701","BUSPIRONE ","TAB 10MG","60","Select","Select",""],["","00065427401","PATADAY ","SOL 0.001","5","Select","Select",""],["","00456111030","VIIBRYD ","TAB 10MG","30","Select","Select",""],["","80777027399","MODERNA ","INJ COVID-19","0.5","Select","Select",""],["","00193658621","MICROLET ","MIS LANCETS","100","Select","Select",""],["","00121057716","LACTULOSE ","SOL 10GM\/15","473","Select","Select",""],["","11822060597","RA ","LIE F 10 MG T","30","Select","Select",""],["","16729021616","SERTRALINE ","TAB 50MG","30","Select","Select",""],["","00591544305","PREDNISONE ","TAB 20MG","14","Select","Select",""],["","00378395105","ATORVASTATIN ","TAB 20MG","90","Select","Select",""],["","59148003713","REXULTI ","1MG","30","Select","Select",""],["","65862055990","PANTOPRAZOLE ","20MG","90","Select","Select",""],["","00597015230","JARDIANCE ","10MG","5","Select","Select",""],["","64980028005","GLIPIZIDE ","5MG","30","Select","Select",""],["","00310620530","FARXIGA ","5MG","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","",""],["N\/A","Select","","","","","Select","",""],["No","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":""}]}]}