{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LAUREN WATERS","gend":1,"add":"PO BOX 1133                                                 ","city":"RICHMOND                      ","state":"VA","zip":"23218-1133","dob":"1993-09-13","age":"","mstatus":"","insh":1565829,"cliId":"","pno":8046153720,"cno":8042386483,"email":"","ename":"","eno":"","pphy":"YOUNG, CHRISTINE M                                          ","ppno":8047989208,"pcpadd":"306 ASHCAKE RD                                              ,                                                            ","pcpcity":"ASHLAND                       ","pcpstate":"VA","pcpzip":230052323,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS INTERNAL MEDICINE OF ASHLAND","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"PO BOX 1133                                                 ","add3":"","madd1":"PO BOX 1133                                                 ","madd2":"                                                            ","madd3":"","mcity":"RICHMOND                      ","mstate":"VA","mzip":"23218-1133","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H65.03","J06.9","R50.9","B34.9","Z72.0","H57.11","H18.211","R10.32","Z32.02","R59.0","Z68.20","R19.7","R11.0","R07.9","Z87.891","R07.81","S20.211A","X50.1XXA","L70.9","N93.9","N92.1","K92.2","R10.9","R74.8","F17.200","N39.0","E86.0","R94.5","K62.5","R16.1","K92.1","N83.201","N76.0","Z11.3","R30.9","F41.9","F33.2","M54.14","Z20.2","S06.0X9A","S01.01XA","W22.8XXA","S09.90XA","W01.10XA","F32.9","R40.2362","R40.2252","R40.2142","Z23","Z68.24","Z20.828","H10.32","N92.6","N94.3","Z11.59","M94.0","R07.89","Z79.3","Z79.899","Z11.52","Z01.411","A60.9","Z01.419","R51.9","J30.89","J01.00","Z68.27","Z20.822","R06.02","J34.2","J34.3","K21.00","L02.92","Z01.818","Z68.31","Z03.818","R05","M25.552","M70.62","M70.61","M25.551","M16.0","G43.109","G44.209","M26.609","M25.562","M25.572","M54.5","G89.29","E87.6","R42","R20.2","R20.0","R22.1","R53.81","F10.11","Z68.30","F43.10","L98.9","D23.9","M54.59","M53.3","M47.816","F33.1","F43.12","F10.14","U07.1","Z30.46","R69","D22.9","M54.50","M47.817","H00.011","K13.0","E66.9","Z68.32","R41.3","R73.09","H92.02","M25.571","M54.16","M43.06","M51.27","Z00.00","E66.09","R21","F43.23","M06.9","F90.0","M51.16","S02.91XA","S02.92XA","L03.211","W57.XXXA","M16.12","M46.1"],"date":["2020-01-02","2021-04-15","2020-01-02","2021-08-19","2020-05-11","2020-01-21","2020-01-21","2020-02-03","2020-02-03","2020-03-06","2020-02-27","2020-03-17","2020-03-17","2021-07-08","2021-07-08","2020-05-05","2020-05-05","2020-05-05","2020-05-08","2020-05-08","2020-05-11","2020-05-11","2020-05-12","2020-05-11","2020-05-11","2020-05-11","2021-07-08","2020-05-11","2020-05-12","2020-05-12","2020-05-12","2020-05-12","2020-05-28","2020-05-28","2020-05-28","2022-07-26","2021-11-12","2020-07-22","2020-07-22","2020-08-10","2020-08-10","2020-08-10","2020-08-10","2020-08-10","2020-08-10","2020-08-10","2020-08-10","2020-08-10","2020-08-10","2020-09-25","2021-08-18","2020-11-16","2021-02-23","2020-12-10","2021-01-06","2021-01-21","2021-01-21","2021-01-21","2022-02-24","2021-05-15","2021-02-23","2021-02-23","2021-02-23","2021-05-05","2021-03-11","2021-03-11","2021-03-11","2022-02-07","2021-03-27","2021-05-05","2021-05-05","2021-05-05","2021-04-07","2021-04-28","2022-02-24","2021-04-30","2021-05-15","2022-11-05","2022-04-18","2022-04-18","2021-11-11","2021-11-12","2022-07-26","2021-06-16","2021-07-26","2021-06-16","2022-05-23","2021-06-16","2021-06-16","2021-07-08","2021-07-08","2021-07-30","2021-07-08","2021-07-30","2021-07-08","2022-07-26","2022-01-26","2021-11-12","2021-12-29","2021-12-29","2022-01-11","2022-04-15","2022-11-07","2022-11-15","2022-11-15","2022-01-26","2022-02-07","2022-02-21","2022-02-24","2022-02-25","2022-05-23","2022-04-05","2022-04-08","2022-04-08","2022-04-08","2022-07-26","2022-05-09","2022-05-09","2022-05-12","2022-05-23","2022-09-29","2022-11-07","2022-11-07","2022-07-26","2022-07-26","2022-07-26","2022-11-22","2022-09-14","2022-11-15","2022-09-29","2022-10-06","2022-10-06","2022-10-10","2022-10-10","2022-11-05","2022-11-07"],"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":[["","68462039710","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","00002143611","EMGALITY","INJ 120MG\/ML","1","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","69238111501","BUSPIRONE","TAB 5MG","45","Select","Select",""],["","16729044416","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","64980041210","PREGABALIN","CAP 75MG","60","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","51991074710","DULOXETINE","CAP 30MG","90","Select","Select",""],["","23155050105","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","62332014271","CELECOXIB","CAP 200MG","30","Select","Select",""],["","","VALACYCLOVIR","TAB 1GM","30","Select","Select",""],["","70700011885","VIENVA","TAB 0.1-20","84","Select","Select",""],["","43547028810","BUPROPION","TAB 100MG SR","90","Select","Select",""],["","57237008863","RIZATRIPTAN","TAB 10MG","9","Select","Select",""],["","00228424106","CLONIDINE","TAB 0.1MG ER","30","Select","Select",""],["","63402030230","LATUDA","TAB 20MG","15","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","14","Select","Select",""],["","62332009730","ARIPIPRAZOLE","TAB 2MG","30","Select","Select",""],["","45802006435","TRIAMCINOLON","CRE 0.001","15","Select","Select",""],["","72819015110","DICLOFEN","TAB 50MG","14","Select","Select",""],["","53489011905","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","59651036205","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","20","Select","Select",""],["","68382031910","TRAMADOL","TAB 50MG","12","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","10","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","62037099901","POT  CL MICRO","TAB 20MEQ ER","10","Select","Select",""],["","00527169505","BUT\/APAP\/CAF","TAB ","15","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","60258015101","SF","GEL 0.011","56","Select","Select",""],["","68462015305","TOPIRAMATE","TAB 50MG","100","Select","Select",""],["","55111029398","SUMATRIPTAN","TAB 100MG","9","Select","Select",""],["","71093014105","METHOCARBAM","TAB 750MG","20","Select","Select",""],["","41167005840","ASPERCREME","PAD LIDO 4%","10","Select","Select",""],["","70700011984","ESTARYLLA","TAB 0.25-35","84","Select","Select",""],["","55111012701","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","65862086001","FAMOTIDINE","TAB 40MG","60","Select","Select",""],["","45802086866","POLYETH","POW 3350 NF","7","Select","Select",""],["","70710122700","AMITRIPTYLIN","TAB 50MG","30","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","20","Select","Select",""],["","00536116134","MUCUS","TAB 30-600ER","20","Select","Select",""],["","70710114003","FLUCONAZOLE","TAB 200MG","2","Select","Select",""],["","24208067004","SOD","SOL 10% OP","15","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":""}]}]}