{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AICIRTAPLLAB A ","gend":1,"add":" KROF   1612DAOR  EGDIR","city":"RAVEN","state":"VA","zip":24639,"dob":"1967-05-09","age":"","mstatus":"","insh":"60016167","cliId":"","pno":"0267235682","cno":"","email":"","ename":"","eno":"","pphy":"TITHA, RAVI K","ppno":2762028653,"pcpadd":"3150 CLINCH ST,","pcpcity":"RICHLANDS","pcpstate":"VA","pcpzip":24641,"pcpcounty":"","pcpid":"","pcpname":"RAVI K TITHA MD","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"SOUTHWEST","aligned":"","ano":"","add2":"2161   FORK RIDGE  ROAD","add3":"","madd1":"2161 FORK RIDGE ROAD","madd2":"","madd3":"","mcity":"RAVEN","mstate":"VA","mzip":"24639-9443","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.65","E55.9","I10","M15.0","J44.9","E87.6","R39.81","R15.9","M54.5","M51.36","E11.3393","E78.2","G61.9","R63.3","R21","G44.229","A41.9","N39.0","N76.4","N76.2","E11.40","F41.8","E78.5","R52","B96.1","Z79.4","Z85.038","Z88.8","Z80.3","E11.9","M60.9","R18.8","Z85.048","Z01.810","N76.0","E04.9","Z09","N30.00","C20","D47.3","N39.46","F51.01","E11.42","J41.1","E10.65","Z71.3","L03.818","M54.16","M25.512","Z23","R74.8","R71.8","N13.30","N20.0","N20.1","R10.9","Z79.899","R20.2","N23","R31.9","N13.5","N30.40","Z20.828","F41.9","F32.9","K21.9","Z92.21","R07.9","Z01.818","Z04.89","H60.311","J20.9","M25.562","S80.02XA","S89.92XA","W20.8XXA","Y92.812","W18.39XA","T78.40XA","H16.223","H25.043","H25.813","H02.831","H02.834","H25.812","E11.3593","Z79.84","J01.00","H25.811","E11.3513","J01.80","R06.02","M79.604","B37.49","I73.9","Z77.22","I70.0","Z13.6","Z93.2","R42","M79.609","D53.8","E08.40","E53.9","H60.559","R19.7"],"date":["2022-04-06","2021-11-08","2022-01-06","2021-09-09","2022-01-06","2020-01-16","2022-03-14","2022-03-14","2020-09-29","2020-02-10","2021-08-16","2020-04-22","2022-02-07","2021-01-12","2020-12-08","2022-02-07","2020-05-30","2020-10-27","2020-06-10","2020-05-29","2020-10-29","2020-05-27","2020-10-27","2020-05-27","2020-05-27","2022-02-28","2020-05-27","2021-05-11","2020-05-27","2021-09-17","2020-05-27","2020-05-29","2020-10-29","2020-05-28","2020-05-30","2020-06-10","2020-06-10","2021-08-09","2022-03-14","2020-10-13","2020-06-24","2020-07-08","2020-10-27","2021-06-08","2020-07-21","2020-07-21","2020-09-08","2020-10-27","2021-04-08","2021-10-07","2020-10-13","2020-10-13","2020-10-29","2020-10-29","2020-10-30","2020-10-27","2020-10-29","2020-10-27","2020-11-05","2020-10-29","2020-10-30","2020-10-30","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2020-10-29","2021-02-09","2021-03-08","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-06-08","2021-08-16","2021-08-16","2021-09-17","2021-09-17","2021-09-17","2021-10-27","2021-11-05","2021-11-05","2021-11-08","2021-12-03","2022-02-28","2022-01-06","2022-01-13","2022-02-07","2022-02-07","2022-03-15","2022-03-15","2022-03-15","2022-03-15","2019-05-30","2019-04-02","2019-04-02","2019-04-10","2019-05-02","2019-10-09","2019-11-04","2019-11-04"],"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":[["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","70377002711","ATORVASTATIN","TAB 10MG","90","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","57237001401","TAMSULOSIN","CAP 0.4MG","5","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","00310621030","FARXIGA","TAB 10MG","30","Select","Select",""],["","59762135401","PREGABALIN","CAP 200MG","90","Select","Select",""],["","10702025350","BUT\/APAP\/CAF","TAB ","120","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","68382075810","METFORMIN","TAB 500MG","60","Select","Select",""],["","81131031179","INSULIN","MIS 0.3\/31G","30","Select","Select",""],["","31722070190","LOSARTAN","TAB 50MG","90","Select","Select",""],["","00002821501","HUMULIN","INJ U-100","10","Select","Select",""],["","08290320119","BD  PEN NEEDL","MIS 31GX5MM","100","Select","Select",""],["","00093078701","ATENOLOL","TAB 25MG","30","Select","Select",""],["","68645055154","LISINOPRIL","TAB 5MG","30","Select","Select",""],["","50228017805","GABAPENTIN","TAB 800MG","90","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68382080601","TRAZODONE","TAB 100MG","30","Select","Select",""],["","00832532511","POT  CL MICRO","TAB 20MEQ ER","60","Select","Select",""],["","70010077001","METHOCARBAM","TAB 750MG","60","Select","Select",""],["","10702020101","OXYBUTYNIN","TAB 5MG","60","Select","Select",""],["","57599000200","FREESTYLE    MIS READER","MIS READER","1","Select","Select",""],["","31722057330","ESOMEPRA","CAP 40MG DR","30","Select","Select",""],["","60505264907","TIZANIDINE","CAP 4MG","90","Select","Select",""],["","65862053820","LEVOFLOXACIN","TAB 750MG","7","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","00093005301","BUSPIRONE","TAB 5MG","90","Select","Select",""],["","00169368712","LEVEMIR","INJ ","10","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","90","Select","Select",""],["","00555088602","ESTRADIOL","TAB 1MG","22","Select","Select",""],["","68645057390","GLIMEPIRIDE","TAB 4MG","30","Select","Select",""],["","60758011905","PREDNISOLONE","SUS 1% OP","5","Select","Select",""],["","50383066730","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","00904530780","BANOPHEN","CAP 50MG","30","Select","Select",""],["","00002879959","HUMALOG","INJ 100\/ML","15","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","90","Select","Select",""],["","00023577330","REFRESH","SOL MEGA-3","30","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","2","Select","Select",""],["","50428032164","ONE","TAB WOMENS","30","Select","Select",""],["","65862084003","MOXIFLOXACIN","SOL HCL 0.5%","6","Select","Select",""],["","17478062312","SOD","SOL 5% OP","15","Select","Select",""],["","00093083205","CLONAZEPAM","TAB 0.5MG","8","Select","Select",""],["","68462018135","CLOTRIMAZOLE","CRE 0.01","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","24208041010","OFLOXACIN","DRO 0.3%OTIC","10","Select","Select",""],["","45802057178","FEXOFENADINE","TAB 180MG","45","Select","Select",""],["","00574200815","NYSTOP","POW 100000","15","Select","Select",""],["","00006483703","PNEUMOVAX","INJ 25\/0.5","0.5","Select","Select",""],["","58160082152","ENGERIX-B","INJ 20MCG\/ML","1","Select","Select",""],["","58160081912","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","20","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","60","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","70710113803","FLUCONAZOLE","TAB 100MG","10","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","28","Select","Select",""],["","16571020210","DICLOFENAC","TAB 50MG DR","90","Select","Select",""],["","49281040015","ADACEL","INJ ","0.5","Select","Select",""],["","41167432005","ALLEGRA-D","TAB 24 HOUR","30","Select","Select",""],["","58160089852","FLUARIX","INJ 2018-19","0.5","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","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":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}