{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GWENDOLYN DELANEY","gend":1,"add":"701 CHURCH ST APT A1","city":"BLACKSTONE","state":"VA","zip":"23824-9998","dob":"1963-07-02","age":"","mstatus":"","insh":"900038897*01","cliId":"","pno":"434\/292-3119","cno":"","email":"","ename":"","eno":"","pphy":"SWAN, DENNIS D MD","ppno":"434\/292-7261","pcpadd":"213 NORTH MAIN ST","pcpcity":"BLACKSTONE","pcpstate":"VA","pcpzip":23824,"pcpcounty":"","pcpid":"","pcpname":"BLACKSTONE FAMILY PRACTICE CENTER","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/292-7965","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R39.81","K92.1","N39.0","N60.01","R92.8","N63.10","I10.","Z68.22","C50.811","Z17.1","Z51.11","N63.12","C50.211","Z86.73","Z79.1","Z87.891","Z79.899","Z45.2","M79.89","M79.669","Z68.25","C50.911","Z17.0","N64.1","Z68.24","I67.9","E11.49","G81.91","B20.","E11.9","E66.9","Z92.21","Z12.11","Z85.9","Z21.","L02.412","Z68.26","Z68.23","Z00.00","Z23.","C50.411","L02.611","B35.1","B35.3","L60.0","Z01.810","M25.561","R35.0","Z01.818","Z20.822","I49.3","Z68.21","G62.0","T45.1X5A"],"date":["2020-10-16","2020-10-16","2021-09-08","2020-12-14","2020-12-14","2020-12-14","2021-12-01","2020-12-30","2021-12-01","2021-12-01","2021-05-18","2020-12-03","2021-01-05","2021-07-20","2021-07-20","2021-07-20","2021-10-05","2021-01-05","2021-05-25","2021-05-25","2021-07-12","2021-07-21","2021-07-20","2021-07-20","2021-08-16","2021-09-08","2021-09-08","2021-09-08","2021-10-27","2021-07-20","2021-07-20","2021-07-20","2021-05-23","2021-05-25","2021-05-25","2021-04-13","2021-05-25","2021-10-20","2021-09-08","2020-10-28","2021-04-15","2021-05-26","2021-05-26","2021-05-26","2021-05-26","2021-07-16","2021-06-15","2021-09-08","2021-07-16","2021-07-16","2021-07-16","2021-12-01","2021-05-11","2021-05-11"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"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":[]},{"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":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","60432060416","PROMETHAZINE\/DEXTROMETHORPHAN                                         ","DM","120","Select","Select",""],["","49702022813","TIVICAY                                                               ","50MG","-30","Select","Select",""],["","61958200201","DESCOVY                                                               ","200\/25","30","Select","Select",""],["","59676057530","PREZCOBIX                                                             ","800-150","30","Select","Select",""],["","65162027250","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS                                      ","800-160","20","Select","Select",""],["","64380073706","VITAMIN D                                                             ","50000UNT","4","Select","Select",""],["","52565000730","LIDOCAINE\/PRILOCAINE                                                  ","2.5-2.5%","30","Select","Select",""],["","59746011506","PROCHLORPERAZINE MALEATE                                              ","10MG","50","Select","Select",""],["","66993068330","OLANZAPINE                                                            ","10MG","8","Select","Select",""],["","55111015430","ONDANSETRON HYDROCHLORIDE                                             ","8MG","24","Select","Select",""],["","31722094201","HYDROCODONE BITARTRATE\/ACETAMINOPHEN                                  ","7.5-325","20","Select","Select",""],["","57237001830","DULOXETINE HYDROCHLORIDE                                              ","30MG","30","Select","Select",""],["","52536010503","ERYTHROMYCIN BASE                                                     ","500MG BS","20","Select","Select",""],["","72140011020","EUCERIN                                                               ","","500","Select","Select",""],["","49281042150","FLUZONE QUADRIVALENT 2021-2022                                        ","2021-22","0","Select","Select",""]]}},{"a":[]},{"a":[]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"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":"","a13":""}]}]}