{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RONALD   A HUTTON","gend":0,"add":"530 N KENT STREET","city":"WINCHESTER","state":"VA","zip":"22601-5346","dob":"1960-12-27","age":"","mstatus":"","insh":10127177,"cliId":"","pno":5405516239,"cno":5405516239,"email":"","ename":"","eno":"","pphy":"LAMAS RODRIGUEZ, CANDY","ppno":5407222369,"pcpadd":"525 Amherst St Ste 104, ","pcpcity":"Winchester","pcpstate":"VA","pcpzip":226013881,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"530 N KENT STREET","madd2":"                                                            ","madd3":"","mcity":"WINCHESTER","mstate":"VA","mzip":"22601-5346","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.29","N39.0","R10.31","F17.200","Z87.440","N49.3","A41.9","E11.65","I95.9","J44.9","M72.6","N50.89","E11.9","I10","I25.10","B37.9","R11.2","N40.1","N32.0","L02.215","R10.2","A02.1","E11.10","R65.21","L03.315","N13.8","N17.9","Z68.36","K21.9","E66.01","R33.8","N50.819","Z87.438","E11.8","R53.1","R34","Z48.1","R33.9","Z48.816","N49.2","E78.5","F17.210","Z79.4","B37.49","Z68.39","B95.1","N40.0","Z20.828","N36.8","N35.919","I45.10","E78.00","J45.909","D72.829","F10.10","R42","N30.90","R11.0","J96.90","D72.9","K62.89","Z20.822","Z86.79","Z86.39","Z46.82","N28.1","N30.00","N48.29","N32.89","K42.9","K43.9","L72.0","I25.2","Z68.41","G47.30","I21.4","Z79.82","Z82.49","R50.9","R19.7","M25.561","J81.1","N39.9","B96.20","E78.2","Z68.32","Z91.14","N21.0","K61.0"],"date":["2020-08-10","2020-06-02","2020-07-12","2020-07-06","2019-01-27","2020-07-06","2020-03-11","2021-03-10","2020-03-02","2020-04-02","2020-03-10","2020-03-10","2020-07-12","2021-03-04","2021-03-04","2020-03-06","2020-03-17","2020-06-02","2021-03-04","2021-03-10","2021-03-04","2020-03-02","2020-03-11","2020-03-02","2020-03-06","2020-03-02","2020-03-02","2020-03-02","2020-03-02","2021-03-04","2020-04-18","2020-04-16","2020-03-17","2020-03-17","2020-03-17","2020-03-17","2020-04-15","2020-05-15","2020-04-18","2020-04-18","2020-04-18","2020-04-18","2020-04-18","2021-03-04","2021-03-04","2021-03-09","2021-03-04","2021-03-04","2021-03-04","2021-03-04","2021-03-04","2021-03-04","2021-03-04","2021-03-10","2021-03-10","2019-01-17","2019-01-27","2020-03-07","2020-03-04","2021-03-04","2021-03-04","2021-03-04","2021-03-04","2021-03-04","2020-03-02","2020-05-15","2020-07-12","2021-03-04","2020-07-12","2020-07-12","2020-07-12","2019-02-08","2019-02-08","2019-02-08","2020-03-17","2019-02-08","2019-02-08","2019-02-08","2020-03-02","2020-03-02","2020-08-10","2020-03-02","2020-03-17","2020-03-17","2020-03-17","2020-03-17","2020-03-17","2020-06-02","2021-03-04"],"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":[["","68382013201","TAMSULOSIN ","CAP 0.4MG","30","Select","Select",""],["","68645049554","ATORVASTATIN ","TAB 80MG","30","Select","Select",""],["","68645057559","GLIPIZIDE ","TAB 10MG","60","Select","Select",""],["","68645054659","METFORMIN ","TAB 1000MG","60","Select","Select",""],["","68645055054","LISINOPRIL ","TAB 2.5MG","30","Select","Select",""],["","65862035705","CLOPIDOGREL ","TAB 75MG","30","Select","Select",""],["","16714048203","LORATADINE ","TAB 10MG","34","Select","Select",""],["","57664050652","METOPROL ","TAB 25MG","60","Select","Select",""],["","00088221905","LANTUS ","INJ 100\/ML","15","Select","Select",""],["","43598043611","NITROGLYCERN ","SUB 0.4MG","25","Select","Select",""],["","68180012202","CEPHALEXIN ","CAP 500MG","28","Select","Select",""],["","08396902400","RELION ","MIS 31GX1\/4\"","50","Select","Select",""],["","49035065082","EQ ","TAB 20MG","180","Select","Select",""],["","68382005105","MELOXICAM ","TAB 15MG","30","Select","Select",""],["","65862007701","CIPROFLOXACN ","TAB 500MG","14","Select","Select",""],["","11822003960","RA ","CAP 100MG","30","Select","Select",""],["","00406012301","HYDROCO\/APAP ","TAB 5-325MG","15","Select","Select",""],["","00193725201","CONTOUR ","KIT NEXT EZ","1","Select","Select",""],["","68462010530","ONDANSETRON ","TAB 4MG","20","Select","Select",""],["","00904404073","ASPIRIN ","CHW 81MG","30","Select","Select",""],["","87701040813","MELATONIN ","TAB 3MG","30","Select","Select",""],["","00536344238","CEROVITE ","TAB ADVANCED","30","Select","Select",""],["","94046000174","PEN  NEEDLES  ","MIS 31GX5MM","100","Select","Select",""],["","65862050301","AMOX\/K ","TAB 875-125","28","Select","Select",""],["","66993001968","ALBUTEROL ","AER HFA","18","Select","Select",""],["","00093220305","METOCLOPRAM ","TAB 10MG","20","Select","Select",""],["","42858010201","OXYCOD\/APAP ","TAB 5-325MG","20","Select","Select",""],["","00193658621","MICROLET ","MIS LANCETS","100","Select","Select",""],["","87701040729","VITAMIN ","TAB 100MG","30","Select","Select",""],["","68001025204","FLUCONAZOLE ","TAB 100MG","14","Select","Select",""],["","69315012701","FOLIC ","TAB 1000MCG","30","Select","Select",""],["","65862042005","SMZ\/TMP ","800-160","20","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":""}]}]}