{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CASSIE   M DURRELL","gend":1,"add":"305 BROADWAY ROAD","city":"WYTHEVILLE","state":"VA","zip":"24382-5454","dob":"1970-04-26","age":"","mstatus":"","insh":4570388,"cliId":"","pno":2766136390,"cno":2766136390,"email":"","ename":"","eno":"","pphy":"DOVE, SCOTTY G","ppno":2762270460,"pcpadd":"791 Fort Chiswell Rd, Ste A","pcpcity":"Max Meadows","pcpstate":"VA","pcpzip":243604139,"pcpcounty":"","pcpid":"","pcpname":"WYTHE COUNTY PHYSICIAN PRACTIC","ano":"","add2":"                                                            ","add3":"","madd1":"305 BROADWAY ROAD","madd2":"                                                            ","madd3":"","mcity":"WYTHEVILLE","mstate":"VA","mzip":"24382-5454","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R53.81","E03.9","E11.42","R39.9","R10.30","E53.8","J20.9","M54.5","M54.32","B34.9","R10.9","E83.42","E78.2","Z91.018","K76.0","M53.3","S33.2XXA","Z91.81","W19.XXXA","Z01.419","Z11.51","Z87.410","R87.810","M79.662","M54.42","R10.32","N95.0","Z12.31","M25.552","M47.27","M54.16","M51.16","M51.17","M43.17","R10.11","B37.2","S32.2XXD","J18.9","A41.9","J96.01","E86.0","E11.9","L70.9","I10","R65.20","E87.6","F34.1","R53.83","D68.51","G62.9","F41.9","R07.89","R11.2","R20.2","R10.12","R07.9","R06.02","Z79.899","R05","R00.2","M47.897","M51.27","M99.53","R79.1","U07.1","M70.62","M46.1","M76.32","J30.9","E28.2","A41.89","R50.9","J12.89","E11.40","E11.65","E66.9","F32.9","E78.5","R21","R93.89","B27.90","L02.92","K74.60","K42.9","J01.00","Z87.442","R16.1","R00.8","J06.9","J30.2","E55.9","I95.1","E88.89","R42","Z88.0","Z88.2","Z86.711","G90.09","L30.9","K08.89"],"date":["2020-02-07","2021-04-21","2020-08-18","2020-03-03","2020-01-29","2021-04-21","2019-12-06","2020-08-18","2019-11-01","2019-12-06","2020-02-07","2021-04-12","2020-08-18","2020-04-01","2020-04-01","2020-08-18","2020-08-18","2020-08-18","2020-08-18","2019-04-10","2019-04-10","2019-04-10","2019-04-10","2019-07-02","2019-07-02","2020-02-07","2019-03-21","2019-04-11","2019-08-29","2020-02-15","2020-02-15","2020-03-16","2020-02-15","2020-02-15","2020-02-18","2020-08-20","2020-08-20","2020-09-07","2020-09-07","2020-09-04","2020-09-04","2021-04-21","2021-04-21","2021-04-21","2020-09-07","2020-09-07","2021-04-12","2020-02-07","2020-09-04","2020-08-18","2021-04-12","2019-05-22","2020-02-11","2019-05-21","2019-05-21","2019-09-15","2020-09-06","2020-01-10","2020-09-04","2020-01-10","2020-02-15","2020-02-15","2020-02-15","2020-09-04","2020-12-10","2019-07-19","2019-07-11","2019-07-11","2020-03-03","2020-03-03","2020-09-04","2020-09-04","2020-09-07","2020-09-04","2020-09-06","2020-09-04","2020-09-04","2021-04-12","2020-12-10","2019-03-21","2019-05-29","2019-05-29","2020-01-29","2020-01-29","2019-12-06","2019-12-06","2020-02-07","2020-02-11","2021-04-12","2020-09-01","2021-04-12","2019-09-15","2019-09-15","2019-09-15","2019-09-15","2019-09-15","2019-09-15","2020-02-03","2020-03-19","2021-04-14"],"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":[["","00093762698","PREGABALIN ","CAP 150MG","90","Select","Select",""],["","00378718705","METFORMIN ","TAB 1000MG","60","Select","Select",""],["","69238183801","LEVOTHYROXIN ","TAB 150MCG","30","Select","Select",""],["","16729018201","HYDROCHLOROT ","TAB 12.5MG","30","Select","Select",""],["","00071101668","LYRICA ","CAP 150MG","90","Select","Select",""],["","00378395177","ATORVASTATIN ","TAB 20MG","30","Select","Select",""],["","68180029606","DULOXETINE ","CAP 60MG","60","Select","Select",""],["","64980033912","MAG ","TAB 400MG","120","Select","Select",""],["","69452015120","VITAMIN ","CAP 50000UNT","4","Select","Select",""],["","13811071910","NITROFURANTN ","CAP 100MG","14","Select","Select",""],["","00378001805","METOPROL ","TAB 25MG","60","Select","Select",""],["","16571020150","DICLOFENAC ","TAB 75MG DR","60","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","00088221905","LANTUS ","INJ 100\/ML","27","Select","Select",""],["","00591505221","PREDNISONE ","PAK 5MG","21","Select","Select",""],["","69315090505","LORAZEPAM ","TAB 1MG","10","Select","Select",""],["","68462019005","NAPROXEN ","TAB 500MG","60","Select","Select",""],["","57237000511","FLUCONAZOLE ","TAB 150MG","2","Select","Select",""],["","00002143480","TRULICITY ","INJ 1.5\/0.5","2","Select","Select",""],["","70010075401","METHOCARBAM ","TAB 500MG","30","Select","Select",""],["","66689000802","NYSTATIN ","SUS 100000","120","Select","Select",""],["","00093506105","HYDROXYZ ","TAB 25MG","90","Select","Select",""],["","66993001968","ALBUTEROL ","AER HFA","18","Select","Select",""],["","64980033912","MAGNESIUM-OX ","TAB 400MG","120","Select","Select",""],["","00193731150","CONTOUR ","TES NEXT","50","Select","Select",""],["","65162062750","TRAMADOL ","TAB 50MG","4","Select","Select",""],["","99073070805","FREESTYLE    MIS LITE","MIS LITE","1","Select","Select",""],["","00781808926","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","00597015230","JARDIANCE ","TAB 10MG","30","Select","Select",""],["","10702000350","PROMETHAZINE ","TAB 25MG","30","Select","Select",""],["","59651036205","IBUPROFEN ","TAB 800MG","20","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","100","Select","Select",""],["","53746051105","SPIRONOLACT ","TAB 25MG","30","Select","Select",""],["","42192060716","BROM\/PSE\/DM ","SYP ","120","Select","Select",""],["","00006027731","JANUVIA ","TAB 100MG","30","Select","Select",""],["","00093101042","MUPIROCIN ","OIN 0.02","22","Select","Select",""],["","00074714890","SYNTHROID ","TAB 200MCG","30","Select","Select",""],["","43598081115","CETIRIZINE ","TAB 10MG","30","Select","Select",""],["","00143980305","DOXYCYCL ","CAP 100MG","10","Select","Select",""],["","00406048410","APAP\/CODEINE ","300-30MG","6","Select","Select",""],["","27808003502","HYDROCO\/APAP ","5-325MG","10","Select","Select",""],["","00002773701","INSULIN ","100\/ML","10","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","",""],["N\/A","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":""}]}]}