{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATRICK   M JONES","gend":0,"add":"1056 WILD BRIAR PL CHERYL JONES","city":"FOREST","state":"VA","zip":"24551-9998","dob":"1980-04-10","age":"","mstatus":"","insh":"900040245*01","cliId":"","pno":"434\/525-1505","cno":"","email":"","ename":"","eno":"","pphy":"LEWIS, DANIELLE S MD","ppno":"434\/200-3908","pcpadd":"125 NATIONWIDE DRIVE","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":24502,"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":"434\/200-5948","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R63.3","G80.9","K21.9","G80.0","G40.509","E03.9","Q03.1","G40.419","R53.83","J96.10","Z20.828","E03.8","G47.33","G80.8","K59.09","M25.572","R21.","R39.81","R73.9","G93.49","R60.9","H10.33","I82.403","M24.542","M24.541","M24.50","I10.","Z91.81","M24.522","M24.521","M24.532","M24.531","J42.","M79.89","Z23.","M21.20","R60.0","J20.9","J32.9","R06.2","H10.9"],"date":["2021-05-10","2021-05-10","2021-07-22","2021-11-20","2021-11-23","2021-10-04","2021-07-22","2021-11-02","2021-11-02","2021-09-28","2020-12-14","2021-11-20","2021-04-12","2021-10-04","2021-04-12","2021-05-14","2021-11-20","2021-04-25","2021-04-14","2021-08-30","2021-05-18","2020-10-20","2021-05-19","2021-11-18","2021-11-18","2021-11-20","2021-11-20","2021-11-20","2021-12-18","2021-12-18","2021-12-18","2021-12-18","2021-09-28","2021-09-28","2021-10-04","2021-10-04","2021-11-23","2021-11-23","2021-03-23","2021-03-23","2021-03-23"],"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":[["","74312005535","MAGNESIUM                                                             ","500MG","180","Select","Select",""],["","51224002230","AZITHROMYCIN                                                          ","250MG","1","Select","Select",""],["","62856027230","FYCOMPA                                                               ","2MG","60","Select","Select",""],["","00363013830","SENNA                                                                 ","8.6MG","60","Select","Select",""],["","68462013001","ZONISAMIDE                                                            ","100MG","210","Select","Select",""],["","69238183801","LEVOTHYROXINE SODIUM                                                  ","150MCG","30","Select","Select",""],["","00456120230","LINZESS                                                               ","290MCG","30","Select","Select",""],["","51293062601","PHENOBARBITAL                                                         ","32.4MG","60","Select","Select",""],["","57237004705","DIVALPROEX SODIUM DR                                                  ","250MG DR","270","Select","Select",""],["","00054429731","FUROSEMIDE                                                            ","20MG","30","Select","Select",""],["","11917007630","VITAMIN D                                                             ","1000UNIT","30","Select","Select",""],["","43547040650","CLONAZEPAM                                                            ","0.5MG","10","Select","Select",""],["","63824000886","MUCINEX                                                               ","600MG ER","120","Select","Select",""],["","00093101042","MUPIROCIN                                                             ","2%","22","Select","Select",""],["","65862001501","AMOXICILLIN                                                           ","875MG","14","Select","Select",""],["","74312015605","D3-1000                                                               ","1000UNIT","30","Select","Select",""],["","61314062810","POLYMYXIN B SULFATE\/TRIMETHOPRIM SULFATE                              ","TRIMETHP","10","Select","Select",""],["","00378699152","ALBUTEROL SULFATE                                                     ","0.63MG\/3","75","Select","Select",""],["","00054004544","IPRATROPIUM BROMIDE                                                   ","0.03%","30","Select","Select",""],["","00143980305","DOXYCYCLINE HYCLATE                                                   ","100MG","14","Select","Select",""],["","58160088752","FLUARIX QUADRIVALENT 2021-2022                                        ","2021-22","0","Select","Select",""],["","65862085901","FAMOTIDINE                                                            ","20MG","90","Select","Select",""],["","00378078293","FEXOFENADINE HYDROCHLORIDE                                            ","180MG","90","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS                                      ","800-160","14","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":""}]}]}