{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" L   ATTEROLPIHSNEKNALB","gend":1,"add":"OB OP984 X","city":"OAKWOOD","state":"VA","zip":"24631-9998","dob":"1973-06-26","age":"","mstatus":"","insh":"93200210*49","cliId":"","pno":"94\/6724014-8","cno":"276\/345-2563","email":"","ename":"","eno":"","pphy":"CORTELLESI, THOMAS B DO","ppno":"276\/935-2677","pcpadd":"SUITE 1A 1109 PLAZA DRIVE","pcpcity":"GRUNDY","pcpstate":"VA","pcpzip":24614,"pcpcounty":"","pcpid":"","pcpname":"FAMILY CARE CENTER","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z13.6","F34.1","F41.1","S00.83XA","G44.309","V48.6XXA","S89.91XA","G89.11","S72.141A","S82.251A","Z68.41","S72.361A","S82.431A","R77.8","R07.9","I11.0","J30.2","E11.42","E66.9","E11.65","K21.9","I50.9","F41.0","J44.9","E03.9","M79.604","Z74.09","V47.6XXA","Z30.42","V54.13","V54.16","J09.X2","J44.1","E11.3593","Z79.4","R79.89","R69.","R60.9","I95.9","E10.622","L97.823","T81.32XA","M79.89","I70.293","NO DATA","Z79.82","Z86.79","Z88.1","Z88.0","Z88.2","L97.821","E10.40","Z79.51","Z79.899","I65.22","I73.9","L97.522","R05.","B37.3","M25.531","G56.01","H43.392","Z01.411","N92.0","N85.2","D25.1","V54.15","E10.9","E78.5","I10.","E13.621","S70.01XA","S86.111A","R06.02","W19.XXXA","S82.251K","E11.3293","Z96.1","T14.90XA","L97.511","I89.0","R09.82","E11.621","Z79.01","E55.9","H43.811","S72.91XA","S82.91XA","V89.2XXD","Z74.3","R00.0","V89.2XXA","M25.551","Z47.89","R26.2","M25.561","R53.1","N92.6","Z87.42","Z30.09","R10.2","R10.9","L03.115","T81.9XXA","R26.89","S89.91XS","I87.2","H25.813","E11.9","J30.9","E10.42","M79.672","M20.22","N83.201","D25.2","E11.51","J20.9","J30.1","J45.20","N93.9","H25.811","H26.492","J15.9","R07.1","H26.491","R09.81","H25.812","Z01.810","I25.2","R94.31","H25.043","H52.03","H52.223","H52.4","L97.822","F33.1","Z11.59","J01.90","R05.3","Z63.4"],"date":["2022-02-03","2020-02-25","2022-09-08","2020-09-25","2020-09-25","2021-05-13","2021-04-28","2021-05-13","2021-05-07","2021-05-07","2021-04-29","2021-04-30","2021-04-29","2021-04-29","2021-05-27","2021-04-29","2021-04-29","2021-04-29","2021-04-29","2021-05-06","2021-04-29","2021-10-07","2021-04-29","2022-11-22","2022-02-16","2021-08-02","2021-05-27","2021-05-06","2022-10-24","2022-03-28","2021-12-27","2020-01-24","2020-01-24","2021-03-16","2021-09-10","2021-05-17","2021-05-15","2022-02-16","2021-06-23","2021-09-10","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2021-09-10","2021-10-07","2021-09-10","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2021-10-07","2022-02-03","2021-11-11","2020-01-09","2020-02-14","2021-03-15","2020-08-20","2020-08-20","2021-03-31","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2021-10-22","2021-08-25","2021-08-25","2022-02-16","2020-02-20","2021-05-27","2021-05-27","2021-05-27","2021-05-27","2021-10-22","2020-05-28","2020-05-28","2021-04-28","2022-02-03","2022-02-03","2022-11-22","2020-03-05","2020-03-05","2020-09-23","2020-11-10","2021-04-29","2021-04-28","2021-05-13","2021-04-28","2021-05-03","2021-05-03","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2021-08-02","2020-09-28","2020-09-28","2020-09-28","2020-09-28","2021-02-01","2021-05-13","2021-05-13","2021-05-13","2021-05-13","2021-10-26","2019-04-17","2022-02-16","2019-08-14","2019-11-18","2019-11-18","2019-10-07","2019-10-28","2019-10-28","2019-12-16","2019-04-24","2022-11-22","2019-05-13","2019-05-13","2019-06-19","2019-09-04","2019-05-04","2019-09-06","2019-10-14","2019-03-21","2019-07-16","2019-12-23","2019-12-23","2019-12-23","2019-03-06","2019-03-06","2019-03-06","2019-03-06","2021-10-07","2022-09-08","2022-11-22","2022-04-04","2022-04-04","2022-09-08"],"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":[["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","00002871501","HUMULIN","INJ 70\/30","30","Select","Select",""],["","","NOVOLOG","INJ 100\/ML","","Select","Select",""],["","59762453802","MEDROXYPR","INJ 150MG\/ML","1","Select","Select",""],["","","ATORVASTATIN","TAB 80MG","","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA BL","100","Select","Select",""],["","68001033408","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","00378181710","LEVOTHYROXIN","TAB 175MCG","30","Select","Select",""],["","51991060401","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","08290324912","INSULIN","MIS 1ML\/31G","150","Select","Select",""],["","00904572889","ALLERGY","TAB 10MG","30","Select","Select",""],["","16729011917","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","69315011610","FUROSEMIDE","TAB 20MG","60","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","76204020060","ALBUTEROL","NEB 0.00083","360","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","50383070016","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","45802065087","LORATADINE","TAB 10MG","30","Select","Select",""],["","00310461612","BREZTRI","AER SPHERE","11","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","15","Select","Select",""],["","46122041660","GNP","TAB 600MG","60","Select","Select",""],["","60432060816","PROMETHAZINE","SYP 6.25\/5ML","180","Select","Select",""],["","","INCRUSE","INH 62.5MCG","","Select","Select",""],["","60505003306","PENTOXIFYLLI","TAB 400MG ER","60","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","24208083060","NEO\/POLY\/DEX","SUS 0.1% OP","5","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","68001025320","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","00955100310","ENOXAPARIN","INJ 30\/0.3ML","9","Select","Select",""],["","","CLINDAMYCIN","GEL 0.01","","Select","Select",""],["","","OSELTAMIVIR","CAP 75MG","","Select","Select",""],["","67877056310","METFORMIN","TAB 1000MG","60","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","10","Select","Select",""],["","24208044605","BESIVANCE","SUS 0.006","5","Select","Select",""],["","60505100301","KETOROLAC","SOL 0.005","5","Select","Select",""],["","33342002208","LEVOFLOXACIN","TAB 500MG","10","Select","Select",""],["","23155014201","DOXYCYCL","TAB 100MG DR","20","Select","Select",""],["","00065924007","DUREZOL","EMU 0.0005","5","Select","Select",""],["","60505058204","MOXIFLOXACIN","SOL HCL 0.5%","3","Select","Select",""],["","76204060060","IPRATROPIUM\/","SOL ALBUTER","360","Select","Select",""],["","00378001805","METOPROL","TAB 25MG","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":[]}},{"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":""}]}]}