{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"O   MAILLIWRS YELVARG ","gend":0,"add":"NOTGNIHSAW 118EVIRD ERAUQS ","city":"PULASKI","state":"VA","zip":"24301-2226","dob":"1965-02-16","age":"","mstatus":"","insh":"50012375","cliId":"","pno":"1304571955","cno":"5404182741","email":"","ename":"","eno":"","pphy":"STEWART, KNOTRESHA F","ppno":"5408350500          ","pcpadd":"28 Town Center Dr, ","pcpcity":"Dublin","pcpstate":"VA","pcpzip":"240846069","pcpcounty":"","pcpid":"","pcpname":"RIVER VALLEY HEALTHCARE ASSOCIATES PC","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"811 WASHINGTON SQUARE DRIVE","madd2":"","madd3":"","mcity":"PULASKI","mstate":"VA","mzip":"24301-2226","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","R68.89","K21.9","R11.2","R21","K46.9","J44.9","K63.5","R25.1","R52","R42","R76.8","Z71.6","G62.9","K59.00","F33.1","K22.70","D36.9","K59.09","Z80.0","J30.2","R09.89","K21.0","K29.70","E78.5","F41.9","F17.200","Z86.010","Z11.59","K20.8","K20.9","R13.10","D12.2","D12.5","D12.3","K64.8","E03.9","G89.29","Z79.890","K64.1","D12.6","G89.4","F31.9","Z13.220","F12.90","Z51.81","Z72.0","M54.5","M54.2","M19.90","M50.30","M51.36","M47.816","R55","I65.23","Z87.891","M47.812","M19.112","K59.04","L89.153","J06.9","R05.9","M79.10","Z20.822","M54.9","H25.13","M54.50","E78.2"],"date":["2020-07-21","2020-04-02","2021-11-15","2020-04-20","2020-01-15","2020-04-20","2022-01-12","2020-07-15","2020-04-20","2020-04-20","2020-04-20","2020-04-20","2020-04-20","2020-08-18","2020-07-13","2022-04-01","2020-06-09","2020-03-10","2020-07-22","2020-07-22","2020-04-20","2020-04-20","2020-06-09","2020-06-17","2020-07-13","2020-07-13","2021-11-15","2020-07-15","2020-06-09","2020-06-17","2020-06-24","2020-06-24","2020-07-15","2020-07-15","2020-07-15","2020-07-22","2022-01-19","2020-07-13","2020-07-13","2020-07-15","2020-07-22","2020-08-18","2020-08-18","2021-02-04","2021-02-04","2022-01-19","2022-01-12","2021-09-22","2021-12-02","2022-01-12","2021-02-23","2021-02-23","2021-02-23","2021-09-22","2021-06-10","2021-06-10","2021-06-10","2021-06-10","2021-07-15","2021-09-22","2021-11-15","2021-11-15","2021-11-15","2021-11-15","2021-12-02","2021-12-06","2022-01-19","2022-01-19"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","69238183007","LEVOTHYROXIN","TAB 25MCG","30.00","Select","Select",""],["","65862048901","QUETIAPINE","TAB 25MG","30.00","Select","Select",""],["","65862056090","PANTOPRAZOLE","TAB 40MG","30.00","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","60.00","Select","Select",""],["","70377000215","SIMVASTATIN","TAB 10MG","30.00","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10.20","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","30.00","Select","Select",""],["","64764024060","AMITIZA","CAP 24MCG","60.00","Select","Select",""],["","00254302902","LUBIPROSTONE","CAP 24MCG","60.00","Select","Select",""],["","50111043401","TRAZODONE","TAB 100MG","30.00","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1.00","Select","Select",""],["","69367013506","GABAPENTIN","TAB 800MG","90.00","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","120.00","Select","Select",""],["","29300012510","MELOXICAM","TAB 15MG","30.00","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20.00","Select","Select",""],["","42806001101","SULINDAC","TAB 200MG","180.00","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4,000.00","Select","Select",""],["","00406012505","HYDROCO\/APAP","TAB 10-325MG","120.00","Select","Select",""],["","64380080438","RANITIDINE","TAB 300MG","30.00","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":""}]}]}