{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRADLEY   D VANDYKE","gend":0,"add":"2513 BAPTIST VALLEY ROAD","city":"CEDAR BLUFF","state":"VA","zip":"24609-8650","dob":"1980-07-10","age":"","mstatus":"","insh":8064554,"cliId":"","pno":2767018645,"cno":2762452494,"email":"","ename":"","eno":"","pphy":"YOUSUF, SAMINA","ppno":2768890433,"pcpadd":"142 Highland Dr, ","pcpcity":"Lebanon","pcpstate":"VA","pcpzip":242664636,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":7572662038,"add2":"                                                            ","add3":"","madd1":"2513 BAPTIST VALLEY ROAD","madd2":"                                                            ","madd3":"","mcity":"CEDAR BLUFF","mstate":"VA","mzip":"24609-8650","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.5","F41.1","F32.9","E78.2","F17.210","Z79.899","H16.223","F17.200","K21.9","F11.20","I45.81","Z79.891","G60.3","F33.1","I10","J30.89","T50.905D","S51.811A","S90.32XA","M25.572","W20.1XXA","Y93.H3","Y92.008","E55.9","J20.9","R05","M43.06","R51","M25.562","G62.9","M43.16","J30.1","I11.9","E87.5","S99.922A","J02.9","Z20.828","R51.9","G56.01","G56.02","G56.21","G56.22","R20.3","F11.10","J01.00","E66.3","Z68.26","G56.03","Z13.83","H61.23","Z11.59","G63","F11.23"],"date":["2021-02-02","2019-10-16","2019-05-13","2020-11-11","2020-11-03","2020-09-10","2019-03-12","2021-02-02","2020-06-08","2021-03-12","2019-10-09","2019-10-09","2020-11-03","2020-11-11","2020-08-05","2020-06-08","2021-01-05","2019-04-12","2019-06-04","2019-06-04","2019-06-04","2019-06-04","2019-06-04","2019-10-21","2019-11-19","2019-11-19","2020-11-10","2020-09-10","2021-01-29","2021-02-02","2020-11-10","2019-03-13","2020-11-11","2019-02-13","2019-06-04","2020-04-14","2020-04-14","2020-11-10","2019-12-27","2019-12-27","2019-12-27","2019-12-27","2019-10-16","2020-11-03","2019-11-01","2019-11-13","2019-11-13","2019-12-17","2020-11-03","2020-09-10","2020-06-26","2020-10-02","2020-10-02"],"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":[["","57237004101","PENICILLN ","TAB 500MG","42","Select","Select",""],["","00456111030","VIIBRYD ","TAB 10MG","30","Select","Select",""],["","68462039710","OMEPRAZOLE ","CAP 40MG","90","Select","Select",""],["","67877042801","GABAPENTIN ","TAB 600MG","90","Select","Select",""],["","00591333130","BUPROPN ","TAB 150MG XL","60","Select","Select",""],["","45802065087","LORATADINE ","TAB 10MG","30","Select","Select",""],["","62332000271","FAMOTIDINE ","TAB 40MG","90","Select","Select",""],["","64380080807","IBUPROFEN ","TAB 600MG","270","Select","Select",""],["","70377000415","SIMVASTATIN ","TAB 40MG","90","Select","Select",""],["","57237001760","DULOXETINE ","CAP 20MG","60","Select","Select",""],["","51660052605","ALLERGY ","TAB 10MG","30","Select","Select",""],["","68382018205","BUSPIRONE ","TAB 15MG","60","Select","Select",""],["","00591354105","BUPROPION ","TAB 150MG SR","30","Select","Select",""],["","00093719801","FLUOXETINE ","CAP 40MG","30","Select","Select",""],["","62175045832","BUPREN\/NALOX ","SUB 8-2MG","14","Select","Select",""],["","68001024617","ONDANSETRON ","TAB 4MG ODT","30","Select","Select",""],["","68001023700","CLONIDINE ","TAB 0.1MG","30","Select","Select",""],["","68001036206","CEFDINIR ","CAP 300MG","20","Select","Select",""],["","69452014330","BENZONATATE ","CAP 100MG","15","Select","Select",""],["","55111018010","TIZANIDINE ","TAB 4MG","90","Select","Select",""],["","13668001005","CITALOPRAM ","TAB 20MG","30","Select","Select",""],["","00406012510","HYDROCO\/APAP ","TAB 10-325MG","90","Select","Select",""],["","64380080307","RANITIDINE ","TAB 150MG","60","Select","Select",""],["","00591079021","METHYLPRED ","TAB 4MG","21","Select","Select",""],["","23155050105","HYDROXYZ ","TAB 25MG","45","Select","Select",""],["","58160084252","BOOSTRIX ","INJ ","0.5","Select","Select",""],["","00781261305","AMOXICILLIN ","CAP 500MG","30","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","29300022019","MONTELUKAST ","TAB 10MG","30","Select","Select",""],["","00054001729","PREDNISONE ","TAB 10MG","10","Select","Select",""],["","12496120803","SUBOXONE ","MIS 8-2MG","14","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":""}]}]}