{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOYCE   L PAIGE","gend":1,"add":"218 CALLAWAY LN","city":"FARMVILLE","state":"VA","zip":"23901-9998","dob":"1960-01-14","age":"","mstatus":"","insh":"900042473*01","cliId":"","pno":"434\/603-1052","cno":"","email":"","ename":"","eno":"","pphy":"BONAGIRI, VARA MD","ppno":"434\/392-9000","pcpadd":"1400 MILNWOOD ROAD","pcpcity":"FARMVILLE","pcpstate":"VA","pcpzip":23901,"pcpcounty":"","pcpid":"","pcpname":"FARMVILLE INTERNAL MEDICINE PC","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/392-9214","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R10.9","I10.","C50.919","E55.9","D48.9","Z12.11","D12.3","K57.30","K64.1","Z20.822","K57.32","K76.0","I70.0","N64.4","R16.0","D12.6","D48.1","S46.811A","Z23.","S46.812A","M54.2","R07.89","E78.00","E78.5","R10.30","Z79.899","K57.92","K92.1","R10.32","Z12.31","D12.2","K76.9","F32.9","Z88.2","M19.90","Z85.3","D22.10","Z88.8","J30.9","K63.5","Z90.11","Z01.419","R14.0"],"date":["2021-06-16","2021-06-30","2021-06-24","2021-06-24","2021-06-18","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-03-19","2021-04-09","2021-04-09","2021-04-09","2021-05-15","2021-04-06","2021-06-30","2021-07-22","2021-10-13","2021-11-01","2021-01-29","2021-01-29","2021-01-29","2021-06-30","2021-04-09","2021-04-06","2021-04-06","2021-06-08","2021-04-09","2021-06-08","2021-08-25","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-06-30","2021-08-25","2021-07-22","2021-04-09","2021-06-24","2021-07-20","2021-08-25","2021-12-09","2021-12-09"],"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":[["","59651000305","OMEPRAZOLE DR                                                         ","40MG","90","Select","Select",""],["","65862050320","AMOXICILLIN\/CLAVULANATE POTASSIUM                                     ","875-125","14","Select","Select",""],["","59088081701","LIDOCAINE HCL-HYDROCORTISONE ACETATE WITH ALOE                        ","2.8-0.55","100","Select","Select",""],["","68180072003","AMLODIPINE BESYLATE                                                   ","5MG","90","Select","Select",""],["","65862007701","CIPROFLOXACIN HYDROCHLORIDE                                           ","500MG","14","Select","Select",""],["","71093014005","METHOCARBAMOL                                                         ","500MG","56","Select","Select",""],["","16571020106","DICLOFENAC SODIUM DR                                                  ","75MG DR","30","Select","Select",""],["","69452015120","VITAMIN D                                                             ","50000UNT","12","Select","Select",""],["","13668013701","ESCITALOPRAM OXALATE                                                  ","20MG","90","Select","Select",""],["","70710113908","FLUCONAZOLE                                                           ","150MG","1","Select","Select",""],["","70377000415","SIMVASTATIN                                                           ","40MG","90","Select","Select",""],["","65862057490","MONTELUKAST SODIUM                                                    ","10MG","90","Select","Select",""],["","53746010901","HYDROCODONE\/ACETAMINOPHEN                                             ","5-325MG","10","Select","Select",""],["","50111033401","METRONIDAZOLE                                                         ","500MG","14","Select","Select",""],["","00093312501","DICLOXACILLIN SODIUM                                                  ","500MG","28","Select","Select",""],["","49483060450","IBUPROFEN                                                             ","800MG","40","Select","Select",""],["","24208091055","ERYTHROMYCIN                                                          ","5MG\/GM","7","Select","Select",""],["","59746000103","METHYLPREDNISOLONE DOSE PACK                                          ","4MG","21","Select","Select",""],["","53746010901","HYDROCODONE BITARTRATE\/ACETAMINOPHEN                                  ","5-325MG","10","Select","Select",""],["","69097084507","CYCLOBENZAPRINE HYDROCHLORIDE                                         ","5MG","30","Select","Select",""],["","65162019050","NAPROXEN                                                              ","500MG","20","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":""}]}]}