{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MARY  D COLLIER","gend":1,"add":"201 WHEATLAND CT NE COMMONWEALTH SENIOR LIVING","city":"CHRISTIANSBURG","state":"VA","zip":"24073-9998","dob":"1960-09-22","age":"","mstatus":"","insh":"2325453*01","cliId":"","pno":5403458139,"cno":5403458139,"email":"","ename":"","eno":"","pphy":"LYONS, ARNEDA F NP","ppno":8667657130,"pcpadd":"6701 PETERS CREEK RD STE 110","pcpcity":"ROANOKE","pcpstate":"VA","pcpzip":"24019-9998","pcpcounty":"","pcpid":"","pcpname":"Premier Geriatric Solutions","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":2012289980,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S22.020A","J96.22","F25.9","K21.9","J96.01","G40.909","I10.","E03.9","E78.2","F20.0","W19.XXXA","E11.9","S32.030S","R39.81","R15.9","Z99.3","L22.","F31.9","F33.1","F41.1","F51.01","F11.10","Z20.822","E78.5","E07.9","E66.9","Z79.890","Z79.84","Z68.41","R45.1","R53.1","R26.81","A41.9","R65.20","N39.0","M25.512","U07.1","R06.02","R09.02","R47.02","F41.9","R07.89","M79.601","F03.90","L60.0","B35.1","M20.41","M20.42","M79.674","M79.675","I25.2","R41.82","R40.4","R94.31","E11.41","R19.7","F31.62","N64.4","M25.511","F25.0","R79.81","G89.29","R32.","Z51.81","Z91.81","R52.","M79.603","F90.9","F51.04","F22.","I82.813","F30.9","R44.1","R46.89","J44.9","J96.10","M48.54XA","E66.01","Z79.82","A49.9","M62.838","S22.080A","X58.XXXA","M54.5","B96.89","M54.2","M54.9","Z68.35","V54.27","F29.","A41.51","NO DATA","J18.9","J96.21","N30.00","E66.2","E27.8","E83.42","E86.0","E87.6","R07.9","R53.81","N39.41","R39.198","N81.84","N17.9","M81.0","S32.009A"],"date":["2022-08-02","2022-08-02","2023-04-19","2023-04-19","2022-08-02","2023-02-20","2023-04-19","2023-04-19","2022-10-13","2022-10-13","2023-02-21","2023-04-19","2023-03-07","2023-01-10","2023-01-10","2023-04-19","2023-01-10","2023-04-19","2022-10-20","2022-10-20","2022-02-23","2022-02-14","2022-07-28","2023-04-19","2022-03-04","2023-02-20","2023-02-20","2023-04-19","2023-01-05","2022-03-04","2022-09-08","2022-09-08","2022-07-29","2022-07-29","2023-04-19","2023-02-20","2021-01-19","2021-01-14","2022-11-14","2021-01-14","2021-06-08","2022-11-14","2021-07-16","2021-07-16","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2023-04-10","2022-02-08","2022-07-28","2022-07-28","2022-07-29","2022-12-29","2022-11-14","2021-11-23","2021-07-20","2021-07-20","2022-03-07","2022-05-18","2022-06-09","2023-04-19","2022-06-09","2023-04-19","2021-07-16","2021-07-16","2021-03-03","2022-10-20","2021-06-17","2021-10-20","2022-02-08","2022-02-08","2022-02-08","2023-01-24","2023-01-24","2023-01-05","2023-04-19","2023-04-19","2023-01-12","2023-01-12","2022-02-27","2022-02-27","2021-06-29","2021-07-02","2023-02-20","2023-02-20","2023-02-20","2023-04-19","2022-02-08","2022-07-28","2022-07-28","2022-07-28","2022-07-28","2022-07-28","2022-07-28","2022-07-28","2022-07-28","2022-07-28","2022-07-28","2022-11-14","2021-01-13","2022-01-06","2022-01-06","2022-03-01","2022-07-28","2022-11-14","2023-01-05"],"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":[]},{"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":[["","67777012114","ALCOHOL PREP","PAD ","100","Select","Select",""],["","00904679480","ASPIRIN","81 MG","28","Select","Select",""],["","13668033205","TRAZODONE","TAB 150MG","28","Select","Select",""],["","57896086501","ZINC SULFATE","TAB 220MG","10","Select","Select",""],["","57896087601","VITAMIN D","TAB 1000UNIT","10","Select","Select",""],["","00904052380","VITAMIN C","TAB 500MG","10","Select","Select",""],["","55111053405","DIVALPROEX","TAB 500MG ER","112","Select","Select",""],["","56151146304","TRUE METRIX","TES GLUCOSE","50","Select","Select",""],["","55111012105","ATORVASTATIN","TAB 10MG","28","Select","Select",""],["","00527328243","LEVOTHYROXIN","TAB 75MCG","28","Select","Select",""],["","14539067405","HYDROXYZ PAM","CAP 25MG","30","Select","Select",""],["","43598003601","FLUPHENAZINE","TAB 5MG","84","Select","Select",""],["","70010006310","METFORMIN","TAB 500MG","56","Select","Select",""],["","80681014800","MELATONIN","3 MG","60","Select","Select",""],["","00536132710","ACETAMINOPHE","TAB 325MG","168","Select","Select",""],["","08470104701","UNISTIK 3","MIS COMFORT","50","Select","Select",""],["","69315090410","LORAZEPAM","0.5 MG","90","Select","Select",""],["","68462029855","CLOTRIM\/BETA","CRE DIPROP","45","Select","Select",""],["","59267100002","PFIZER VACC","INJ COVID-19","0","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","224","Select","Select",""],["","68382025605","OXYBUTYNIN","TAB 10MG ER","28","Select","Select",""],["","27808003502","HYDROCO\/APAP","TAB 5-325MG","90","Select","Select",""],["","00093031105","LOPERAMIDE","CAP 2MG","30","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","200","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","10","Select","Select",""],["","69238110005","DOXYCYCL HYC","CAP 100MG","14","Select","Select",""],["","00904679480","ASPIRIN LOW","CHW 81MG","28","Select","Select",""],["","00536104815","ANTACID","CHW 500MG","150","Select","Select",""],["","69097082212","CITALOPRAM","TAB 10MG","28","Select","Select",""],["","67877024910","QUETIAPINE","TAB 50MG","84","Select","Select",""],["","13668003805","RISPERIDONE","2 MG","28","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","69315013710","BENZTROPINE","TAB 1MG","30","Select","Select",""],["","45802005911","NYSTATIN","100000\/G","30","Select","Select",""],["","67877021905","CEPHALEXIN","500 MG","28","Select","Select",""],["","19515080852","FLULAVAL QUA","INJ 2022-23","0","Select","Select",""],["","55111015810","OMEPRAZOLE","20 MG","28","Select","Select",""],["","00527328243","LEVOTHYROXINE SODIUM","75 MCG","28","Select","Select",""],["","42858010250","OXYCODONE-ACETAMINOPHEN","5 MG-325MG","180","Select","Select",""],["","68382025605","OXYBUTYNIN CHLORIDE ER","10 MG","28","Select","Select",""],["","67877024910","QUETIAPINE FUMARATE","50 MG","84","Select","Select",""],["","70010006310","METFORMIN HCL","500 MG","60","Select","Select",""],["","69097082212","CITALOPRAM HBR","10 MG","30","Select","Select",""],["","52817033200","CYCLOBENZAPRINE HCL","10 MG","12","Select","Select",""],["","43598083005","ATORVASTATIN CALCIUM","10 MG","28","Select","Select",""],["","55111053405","DIVALPROEX SODIUM ER","500 MG","112","Select","Select",""],["","00536132710","ACETAMINOPHEN","325 MG","168","Select","Select",""],["","43598003601","FLUPHENAZINE HCL","5 MG","84","Select","Select",""],["","16714043901","NITROFURANTOIN MONO-MACRO","100 MG","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"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":""}]}]}