{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ADNARIMNITSUA S","gend":1,"add":"NOHACOP914TEERTS SAT","city":"GLASGOW","state":"VA","zip":"24555-2108","dob":"1984-07-13","age":"","mstatus":"","insh":"50013136","cliId":"","pno":"1840856159","cno":5403535272,"email":"","ename":"","eno":"","pphy":"ROWLAND, MICHAEL C","ppno":4343091165,"pcpadd":"1280 MAIN ST STE A,","pcpcity":"Altavista","pcpstate":"VA","pcpzip":"24517-1465","pcpcounty":"","pcpid":"","pcpname":"ALTAVISTA MEDICAL CENTER","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"419POCAHONTAS STREET","add3":"","madd1":"419POCAHONTAS STREET","madd2":"","madd3":"","mcity":"GLASGOW","mstate":"VA","mzip":"24555-2108","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M79.601","M25.511","M72.2","J01.10","R09.81","R51.9","R10.13","M25.552","M25.562","K21.9","F17.210","E66.01","R07.9","N92.0","Z68.41","F32.9","F41.1","G47.9","R00.2","K61.2","R10.9","N30.01","N94.6","Z79.899","K61.1","R10.2","N39.0","R06.2","R11.2","N80.9","R87.610","Z01.810","L05.91","I05.8","H00.021","H00.011","I10","N73.6","N88.8","N80.0","D26.0","D28.2","Z86.16","Z68.37","I45.10","N80.3","N83.8","N83.01","N83.02","N83.12","N83.10","Z90.710","Z90.722","Z90.79","K52.9","N73.0","N73.9","D72.829","R50.9","N93.9","R11.10","K43.2","E87.6","Z68.39","Z88.1","Z88.5","Z90.49","Z98.891","N30.00","R00.0","T81.40XA","L08.9","Z46.82","K65.1","I49.1","I49.3","A63.0","J98.4","U07.1","L05.01","R04.0","E66.9","R05.9","Z87.891","R21","R00.1","Z01.812","L05.92","F17.290","F32.A","F41.9","Z79.890","K43.9","R19.7","R82.4","R74.8","E80.7","K76.0","R16.0","Z87.19","R10.12","L03.211","R22.0","K42.9","K43.6"],"date":["2021-03-15","2021-03-29","2021-10-07","2021-06-06","2022-09-09","2022-09-09","2022-12-24","2022-01-25","2022-01-25","2023-04-06","2022-04-11","2022-04-21","2022-05-05","2022-03-02","2022-04-19","2023-04-17","2023-03-20","2023-04-17","2022-05-05","2022-02-09","2023-04-06","2022-02-09","2022-04-08","2023-04-06","2022-02-09","2022-04-08","2022-02-16","2022-02-16","2022-12-24","2022-04-11","2022-02-17","2022-11-10","2022-11-14","2022-03-04","2022-03-11","2022-03-12","2023-04-17","2022-04-11","2022-04-08","2022-04-08","2022-04-11","2022-04-11","2022-04-08","2022-04-08","2022-04-11","2022-04-11","2022-04-11","2022-04-11","2022-04-11","2022-04-11","2022-04-11","2022-12-24","2022-04-11","2022-04-11","2022-04-21","2022-04-25","2022-04-24","2023-04-06","2022-04-21","2022-04-21","2022-04-21","2022-04-21","2023-04-06","2022-04-21","2022-11-14","2022-11-14","2022-12-24","2022-04-21","2022-04-21","2022-04-21","2022-04-21","2022-04-22","2022-04-24","2022-04-24","2022-05-05","2022-05-05","2023-05-02","2022-09-09","2022-09-09","2022-11-14","2022-09-09","2022-09-09","2022-09-09","2022-09-09","2022-10-18","2022-11-10","2022-11-10","2022-11-14","2022-11-14","2022-11-14","2022-11-14","2022-11-14","2023-04-06","2022-12-24","2022-12-24","2022-12-24","2022-12-24","2023-04-06","2022-12-24","2022-12-24","2022-12-24","2023-03-07","2023-03-07","2023-04-06","2023-04-18"],"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":[["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","30","Select","Select",""],["","68382097001","CHLORTHALID","TAB 25MG","30","Select","Select",""],["","00555088602","ESTRADIOL","TAB 1MG","30","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","68645056259","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","6.7","Select","Select",""],["","00603533815","PREDNISONE","PAK 10MG","21","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","30","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","28","Select","Select",""],["","65862050130","AMOX\/K CLAV","TAB 250-125","42","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","90","Select","Select",""],["","65862048901","QUETIAPINE","TAB 25MG","90","Select","Select",""],["","16729020201","BUSPIRONE","TAB 10MG","90","Select","Select",""],["","65862039110","ONDANSETRON","TAB 8MG ODT","10","Select","Select",""],["","49884015576","VARENICLINE","TAB 0.5MG","11","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","3.5","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","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":["",""],"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":""}]}]}