{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN   E HALL","gend":0,"add":"1037 LARK ST","city":"BEDFORD","state":"VA","zip":"24523-9998","dob":"1947-08-11","age":"","mstatus":"","insh":"900039655*01","cliId":"","pno":"540\/297-4031","cno":"","email":"","ename":"","eno":"","pphy":"DEHLI, TODD H MD","ppno":"540\/297-7181","pcpadd":"4830 RUCKER RD","pcpcity":"MONETA","pcpstate":"VA","pcpzip":24121,"pcpcounty":"","pcpid":"","pcpname":"CENTRA MEDICAL GROUP LLC","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"ROANOKE ALLEGHANY","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/297-6145","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I25.10","K65.1","A41.51","L02.31","A41.9","G89.18","A41.50","E87.2","E87.6","E87.1","N17.9","E11.65","I10.","E46.","R63.4","E78.4","F32.9","B35.1","R15.9","R32.","Z93.3","K80.20","R79.89","R74.01","I96.","I47.1","I73.9","Z72.0","Z43.3","E11.628","Z89.511","S81.002D","E78.2","E11.9","Z89.512","Z87.891","Z91.048","Z79.82","Z79.02","X58.XXXD","Y92.89","T87.44","Z20.822","R65.20","G93.41","L89.893","E11.52","K94.09","D62.","M86.9","T87.54","T87.81","T87.89","T87.40","A49.9","D72.829","E11.69","R06.00","I70.209","K29.00","R39.81","I63.9","S31.811D","L89.619","E11.51","F17.210","Z79.4","Z86.73","E43.","Z51.5","Z20.828","L89.894","L89.614","I69.351","L03.115","E11.649","Z68.20","E16.2","I67.858","Z74.3","R00.0","K46.9","N19.","I69.30","R06.6","D64.9","Z89.519","G54.6","E83.42","Z29.9","L97.822","M79.674","R74.02","Z47.81","L84.","M48.00","Z91.81","Z12.11","E11.621","L97.529","Z79.899","M79.672","I69.398","R29.818","E55.9","Z89.432","I95.9","T81.49XA","B96.4","B96.20","Z79.84","L89.152","G54.7","I49.9","S88.111A","L97.429","S91.302A","E11.42","K21.9","F01.51","I70.0","L08.9","S78.119A","R91.8","M79.18","R07.9","R53.1","M85.80","M17.12","Z09.","L02.211","N30.00","R53.83","I49.8","Z74.01","I35.0","E78.9","K63.1","K63.2","E44.0","Z68.23","E83.39","E86.0","I70.269","N17.0","I70.262","L03.116","N39.0","K43.5","B95.7","I69.328","S88.112A","M79.605","Y83.8","Z71.89","Z23.","I70.261","M19.072","M79.89","L97.329","I99.8","R60.0","D47.3","M01.X72","Z89.9","T14.8XXA"],"date":["2021-09-14","2020-09-14","2020-08-11","2020-09-14","2021-10-20","2021-10-18","2020-09-14","2021-08-22","2021-10-15","2021-10-15","2021-09-29","2021-10-16","2021-11-28","2020-11-02","2020-09-14","2020-08-12","2021-11-28","2020-09-14","2020-10-15","2021-11-28","2021-10-13","2021-08-11","2020-10-17","2020-10-17","2021-10-18","2020-11-02","2021-10-20","2021-09-29","2021-12-04","2021-08-08","2021-11-28","2021-09-28","2021-11-28","2021-09-28","2021-10-16","2021-09-28","2021-09-28","2021-09-29","2021-09-28","2021-09-28","2021-09-28","2021-11-28","2021-10-08","2021-10-08","2021-10-16","2021-11-28","2021-10-08","2021-10-08","2021-10-16","2021-10-10","2021-10-08","2021-10-10","2021-11-28","2021-10-20","2021-10-20","2021-10-20","2021-10-20","2020-07-21","2020-07-21","2020-07-21","2020-10-15","2020-11-20","2020-09-14","2020-10-16","2021-11-28","2020-10-16","2021-10-15","2020-11-02","2020-10-17","2020-10-30","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-17","2020-10-31","2020-10-31","2020-10-31","2021-10-08","2021-03-03","2021-08-11","2021-10-09","2021-08-22","2021-10-01","2021-10-01","2021-09-08","2021-10-15","2021-10-15","2021-10-16","2020-10-16","2020-10-31","2021-09-29","2020-11-02","2020-11-02","2021-09-29","2021-05-23","2021-08-08","2021-08-08","2021-09-20","2021-08-08","2021-11-28","2021-11-28","2021-11-28","2021-09-29","2021-10-08","2021-10-08","2021-11-28","2021-11-28","2021-11-28","2021-11-28","2021-11-28","2020-10-28","2021-02-10","2021-08-08","2021-08-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-20","2021-11-03","2020-07-27","2021-06-04","2021-10-08","2021-10-08","2021-10-15","2021-10-15","2021-10-29","2020-07-21","2020-07-21","2020-07-21","2020-10-16","2020-10-16","2020-07-13","2020-07-13","2020-07-22","2020-07-22","2020-07-22","2020-07-22","2020-07-22","2020-07-22","2020-10-21","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-08-08","2021-10-08","2021-10-08","2021-10-08","2020-10-30","2021-09-22","2021-02-10","2021-08-08","2021-08-08","2021-08-08","2021-08-14","2021-08-15","2021-10-16","2021-08-08","2021-10-01","2021-10-01"],"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":[["","68645049554","ATORVASTATIN CALCIUM                                                  ","80MG","90","Select","Select",""],["","00591578301","ATENOLOL\/CHLORTHALIDONE                                               ","100-25MG","90","Select","Select",""],["","08290320122","BD PEN NEEDLE\/NANO\/ULTRA -FINE\/32G X 4MM                              ","32GX4MM","100","Select","Select",""],["","31722071390","PANTOPRAZOLE SODIUM                                                   ","40MG","30","Select","Select",""],["","68382039801","POTASSIUM CHLORIDE ER                                                 ","20MEQ ER","-30","Select","Select",""],["","68645058459","METFORMIN HYDROCHLORIDE                                               ","1000MG","-60","Select","Select",""],["","00169643810","LEVEMIR FLEXTOUCH                                                     ","FLEXTOUC","15","Select","Select",""],["","00597015390","JARDIANCE                                                             ","25MG","90","Select","Select",""],["","43547028111","ESCITALOPRAM OXALATE                                                  ","10MG","30","Select","Select",""],["","57237010099","METOPROLOL TARTRATE                                                   ","25MG","60","Select","Select",""],["","00143924920","AMOXICILLIN\/CLAVULANATE POTASSIUM                                     ","875-125","10","Select","Select",""],["","43598071901","CHLORTHALIDONE                                                        ","25MG","30","Select","Select",""],["","16714069101","FLUCONAZOLE                                                           ","100MG","20","Select","Select",""],["","65862019899","GABAPENTIN                                                            ","100MG","30","Select","Select",""],["","31722094101","HYDROCODONE BITARTRATE\/ACETAMINOPHEN                                  ","5-325MG","5","Select","Select",""],["","50111078751","AZITHROMYCIN                                                          ","250MG","6","Select","Select",""],["","53885092701","ONETOUCH VERIO REFLECT                                                ","VERIO RE","1","Select","Select",""],["","65702073110","ACCU-CHEK GUIDE ME                                                    ","GUIDE ME","1","Select","Select",""],["","53885027210","ONETOUCH VERIO TEST STRIPS                                            ","VERIO","200","Select","Select",""],["","00006022131","JANUVIA                                                               ","25MG","30","Select","Select",""],["","31722052001","HYDRALAZINE HYDROCHLORIDE                                             ","25MG","90","Select","Select",""],["","57896030410","STOOL SOFTENER\/LAXATIVE                                               ","8.6-50MG","28","Select","Select",""],["","49035008424","                                                                      ","","28","Select","Select",""],["","68645051554","AMLODIPINE BESYLATE                                                   ","5MG","60","Select","Select",""],["","00245010810","FERROUS SULFATE                                                       ","325MG EC","60","Select","Select",""],["","00406051201","OXYCODONE\/ACETAMINOPHEN                                               ","5-325MG","13","Select","Select",""],["","64980052810","SODIUM BICARBONATE                                                    ","650MG","56","Select","Select",""],["","57664037713","TRAMADOL HCL                                                          ","50MG","18","Select","Select",""],["","57237001760","DULOXETINE HYDROCHLORIDE                                              ","20MG","60","Select","Select",""],["","39328006412","H-CHLOR 12                                                            ","0.13%","473","Select","Select",""],["","31722058690","NEBIVOLOL HYDROCHLORIDE                                               ","5MG","90","Select","Select",""],["","00603028332","SENNALAX-S                                                            ","8.6-50MG","30","Select","Select",""],["","49035016130","EQ SENNA-S                                                            ","8.6-50MG","30","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":["",""]}},{"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":""}]}]}