{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SHANNON   N LOWE","gend":1,"add":"17394 RUST HOLLOW RD","city":"ABINGDON","state":"VA","zip":"24210-8338","dob":"1984-10-11","age":"","mstatus":"","insh":7785921,"cliId":"","pno":2762069440,"cno":2762069440,"email":"","ename":"","eno":"","pphy":"PENNINGS, SIMON P","ppno":2767398010,"pcpadd":"603 Campus Dr, Ste 100","pcpcity":"Abingdon","pcpstate":"VA","pcpzip":242109700,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"17394 RUST HOLLOW RD","madd2":"                                                            ","madd3":"","mcity":"ABINGDON","mstate":"VA","mzip":"24210-8338","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R41.3","R90.82","G43.009","F32.9","R21","L08.9","R10.9","R10.84","G35","M54.9","Z79.899","F41.0","G89.29","K59.00","F17.210","K58.1","R22.1","L02.91","M21.6X1","M77.42","M79.672","M79.671","K30","R11.0","M25.50","Z90.49","M47.814","N83.202","F41.1","F02.81","R53.83","N30.00","L72.3","Z01.818","Z20.828","M41.9","E78.5","F33.41","R13.10","M54.2","M51.34","L60.0","M79.675","N61.1","E66.9","D58.2","E66.1","Z68.37","R10.30","R10.2","R30.0","Z87.442","N91.2","Z68.41","M47.26","M25.532","G57.93","M51.24","S79.911A","W19.XXXA","F45.8","R13.14","N39.0","R39.9","D12.4","M54.6","M77.9","I73.00","R10.10","G43.709","M25.551","M25.552","M41.80","M71.572","L03.031","M79.674","N64.9","L56.5","L84","M21.6X2","L72.0","M79.89","S70.01XA","M25.651","F41.9","K64.8","E78.2","Z23"],"date":["2021-05-20","2019-07-01","2021-05-20","2021-05-18","2019-08-09","2020-09-18","2020-11-07","2020-03-19","2021-05-20","2019-12-18","2021-05-18","2021-04-14","2021-04-29","2020-05-05","2021-05-18","2020-05-05","2020-09-18","2020-09-08","2021-04-28","2021-04-08","2021-04-28","2021-04-28","2019-01-14","2020-01-02","2019-11-04","2019-06-26","2019-06-26","2019-06-26","2021-04-14","2021-04-14","2021-05-18","2020-04-07","2020-09-18","2020-09-11","2020-09-11","2020-09-18","2020-11-07","2021-04-14","2021-05-18","2021-05-18","2019-07-01","2021-05-13","2021-05-13","2019-12-03","2019-12-04","2020-08-12","2021-04-16","2020-08-12","2020-11-07","2020-11-07","2020-11-07","2020-11-07","2021-04-16","2021-04-16","2021-05-12","2021-04-29","2021-04-29","2019-07-01","2019-11-04","2019-11-04","2020-01-02","2020-01-02","2020-03-12","2020-03-12","2020-03-19","2020-06-05","2019-04-04","2019-04-04","2019-04-17","2019-04-17","2019-11-04","2019-08-13","2020-07-07","2019-01-10","2019-08-08","2019-08-08","2019-12-03","2021-05-13","2020-11-05","2021-04-28","2020-09-18","2020-09-18","2019-11-04","2019-11-04","2019-11-04","2020-03-19","2020-10-09","2020-10-09"],"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":[["","59762122203","DESVENLAFAX ","TAB 100MG ER","30","Select","Select",""],["","65862039010","ONDANSETRON ","TAB 4MG ODT","30","Select","Select",""],["","68382080701","TRAZODONE ","TAB 150MG","30","Select","Select",""],["","63739064510","FAMOTIDINE ","TAB 20MG","30","Select","Select",""],["","59762371901","ALPRAZOLAM ","TAB 0.25MG","15","Select","Select",""],["","13668021730","ARIPIPRAZOLE ","TAB 5MG","30","Select","Select",""],["","31722068060","DIMETHYL ","MIS STARTER","60","Select","Select",""],["","11523433203","CLARITIN-D ","TAB 10-240MG","30","Select","Select",""],["","16714066201","GABAPENTIN ","CAP 300MG","90","Select","Select",""],["","68382013914","TOPIRAMATE ","TAB 50MG","60","Select","Select",""],["","45802086802","POLYETH ","POW 3350 NF","476","Select","Select",""],["","00456120330","LINZESS ","CAP 72MCG","30","Select","Select",""],["","70677003101","SM ","DIS 14MG\/24H","28","Select","Select",""],["","00603548221","PROPRANOLOL ","TAB 10MG","90","Select","Select",""],["","65862052890","VENLAFAXINE ","CAP 75MG ER","30","Select","Select",""],["","00093101042","MUPIROCIN ","OIN 0.02","22","Select","Select",""],["","57237023301","SMZ-TMP ","TAB 800-160","14","Select","Select",""],["","36800019402","ACID ","TAB 20MG","30","Select","Select",""],["","55513084301","AIMOVIG ","INJ 140MG\/ML","1","Select","Select",""],["","00406012301","HYDROCO\/APAP ","TAB 5-325MG","90","Select","Select",""],["","57237000511","FLUCONAZOLE ","TAB 150MG","2","Select","Select",""],["","59746000103","METHYLPRED ","TAB 4MG","21","Select","Select",""],["","13107003134","MIRTAZAPINE ","TAB 15MG","60","Select","Select",""],["","16714007104","BACLOFEN ","TAB 10MG","90","Select","Select",""],["","64380076921","PEG-3350\/KCL ","SOL \/SODIUM","4,000.00","Select","Select",""],["","54295030815","UREA ","CRE 0.4","56.7","Select","Select",""],["","10702000201","PROMETHAZINE ","TAB 12.5MG","4","Select","Select",""],["","23155010205","METFORMIN ","TAB 500MG","60","Select","Select",""],["","68180012202","CEPHALEXIN ","CAP 500MG","21","Select","Select",""],["","65862018501","CLINDAMYCIN ","CAP 150MG","21","Select","Select",""],["","65862019105","CYCLOBENZAPR ","TAB 10MG","20","Select","Select",""],["","00378696112","GLATIRAMER ","INJ 40MG\/ML","12","Select","Select",""],["","16729015615","SIMVASTATIN ","TAB 5MG","30","Select","Select",""],["","00406052201","OXYCOD\/APAP ","TAB 7.5-325","10","Select","Select",""],["","59267100002","PFIZER ","INJ COVID-19","0.3","Select","Select",""],["","00591544210","PREDNISONE ","TAB 10MG","36","Select","Select",""],["","72205001290","PREGABALIN ","CAP 50MG","60","Select","Select",""],["","00472033720","HYDROCORT ","CRE 0.025","20","Select","Select",""],["","68462019005","NAPROXEN ","TAB 500MG","14","Select","Select",""],["","31722071390","PANTOPRAZOLE ","TAB 40MG","30","Select","Select",""],["","00574206130","CICLOPIROX ","GEL 0.0077","30","Select","Select",""],["","00069047103","CHANTIX ","PAK 0.5& 1MG","53","Select","Select",""],["","00378615097","OMEPRAZOLE ","CAP 20MG","30","Select","Select",""],["","62332014231","CELECOXIB ","CAP 200MG","30","Select","Select",""],["","16571020150","DICLOFENAC ","TAB 75MG DR","30","Select","Select",""],["","55253080130","MODAFINIL ","TAB 100MG","30","Select","Select",""],["","51660072415","ALLERGY ","TAB DECONGES","15","Select","Select",""],["","59762040101","SUCRALFATE ","TAB 1GM","60","Select","Select",""],["","65862042001","SMZ\/TMP ","TAB 800-160","14","Select","Select",""],["","00378020801","FUROSEMIDE ","20MG","30","Select","Select",""],["","57237001890","DULOXETINE ","30MG","60","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","",""],["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":""}]}]}