{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRANDI   G BOOTH","gend":1,"add":"526 WENONAH AVENUE","city":"PEARISBURG","state":"VA","zip":"24134-1608","dob":"1986-07-08","age":"","mstatus":"","insh":4105976,"cliId":"","pno":5402687629,"cno":5405778551,"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":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"APT 1","add3":"","madd1":"526 WENONAH AVENUE","madd2":"APT 1","madd3":"","mcity":"PEARISBURG","mstate":"VA","mzip":"24134-1608","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G40.909","R56.9","J45.909","F17.200","R11.10","R32","F10.129","R51","R10.9","Y90.3","Z76.89","E78.5","M51.36","J42","F41.8","G47.00","J30.2","Z91.410","Z87.81","F43.10","G62.9","R31.9","R74.0","Z72.0","R76.8","R68.89","S42.021D","T84.84XD","R10.11","R11.2","R30.0","F32.9","F41.9","Z90.49","T84.84XA","S42.021S","J45.20","B19.20","D64.9","F41.1","F17.210","Z79.51","Z91.89","Z87.01","Z11.59","Z47.2","F19.10","F43.23","R00.0","R45.1","F10.239","F33.2","Y90.6","K21.9","Z59.0","Z88.0","Z88.6","Z56.0","F12.23","F43.11","X83.8XXA","F10.120","M25.511","F11.23","F11.10","F15.10","F12.10","F19.11","Z65.8","Z87.828","F11.20","F33.1","F10.14","F55.8","L03.90","J30.1","M54.6","R03.0","G89.29","J45.30","Z23","Z79.899","R94.31","S46.912A","Z71.89","F10.10","G93.40","R41.82","Z53.21","M54.2","G44.319","W10.9XXA","Y92.89","W19.XXXA","R07.9","S06.2X9A","F44.5","G40.919","M25.562","V89.2XXA","M54.5","X58.XXXA","S09.90XA","S19.9XXA","S22.030A","M25.519","S22.039A","V03.00XA","Y93.01","Y92.410","S29.9XXA","R93.7","R40.4","F39","S22.030D","S22.038D","V03.10XD","T71.9XXA","S22.039D","Y09","S22.008A","Z04.89","M48.54XA","M54.9","G40.409","R40.2441","G40.901","V09.9XXA","Y93.9","S00.81XA","S80.211A","S60.511A","S80.811A","S30.810A","Z72.89","Z46.82","J96.01","Z79.1","Z87.11","Z87.442","Z80.49","Z82.49","Z82.61","J96.00","Z53.20","F44.9","Z99.11","E83.51","G40.501","Z04.3","J45.901","M62.838"],"date":["2020-06-11","2020-02-03","2020-06-02","2020-06-11","2020-02-02","2020-02-02","2020-02-03","2020-02-03","2020-04-06","2020-02-03","2020-02-18","2020-03-20","2020-03-20","2020-03-20","2020-06-03","2020-06-03","2020-03-20","2020-03-20","2020-03-20","2022-03-08","2020-08-11","2020-04-06","2020-03-20","2021-01-25","2020-03-26","2021-02-24","2020-03-25","2020-03-25","2020-04-06","2020-04-06","2020-04-06","2020-06-02","2020-10-21","2020-06-03","2020-05-26","2020-05-20","2021-01-25","2021-01-25","2020-08-11","2020-05-26","2020-06-03","2020-05-26","2020-05-26","2020-05-26","2020-05-26","2020-05-26","2020-06-02","2020-06-23","2020-06-02","2020-06-02","2020-06-11","2020-06-11","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2020-06-03","2020-06-10","2020-06-10","2020-06-10","2020-06-03","2020-06-11","2020-06-11","2020-06-11","2020-06-11","2020-06-11","2020-06-11","2020-06-11","2022-03-31","2020-06-23","2020-06-23","2020-06-23","2020-07-05","2020-10-21","2020-08-11","2020-08-11","2020-08-11","2020-10-21","2020-10-21","2021-01-25","2021-01-25","2021-03-10","2021-03-10","2019-04-13","2019-04-13","2019-02-08","2019-01-15","2019-03-01","2019-01-19","2019-01-19","2019-01-19","2019-01-19","2019-01-19","2019-01-19","2019-04-13","2019-02-06","2019-02-06","2019-04-13","2019-02-06","2019-02-06","2019-02-06","2019-02-06","2019-02-06","2019-02-06","2019-02-06","2019-02-06","2019-02-06","2019-04-12","2019-02-06","2019-02-06","2019-02-08","2019-02-08","2019-02-28","2019-02-28","2019-02-28","2019-03-01","2019-03-01","2019-03-01","2019-03-01","2019-03-01","2019-03-01","2019-03-01","2019-04-11","2019-04-12","2019-04-13","2019-04-13","2019-04-12","2019-04-12","2019-04-12","2019-04-12","2019-04-12","2019-04-12","2019-04-12","2019-04-12","2019-04-13","2019-04-13","2019-04-13","2019-04-13","2019-04-13","2019-04-13","2019-04-13","2019-04-13","2019-04-13","2019-04-13","2019-04-13","2019-04-13","2019-04-13","2019-04-13","2019-04-21","2019-04-21"],"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":[["","71921017309","VENLAFAXINE","CAP 75MG ER","90","Select","Select",""],["","65862049101","QUETIAPINE","TAB 100MG","60","Select","Select",""],["","68382056928","ACAMPRO","TAB 333MG","30","Select","Select",""],["","13668021930","ARIPIPRAZOLE","TAB 15MG","30","Select","Select",""],["","00904645780","DOK","CAP 100MG","30","Select","Select",""],["","70954001910","PRAZOSIN","CAP 1MG","60","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","10","Select","Select",""],["","13107003134","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","43598044770","NICOTINE","DIS 14MG\/24H","7","Select","Select",""],["","00135046702","NICORETTE","GUM 4MG CINN","100","Select","Select",""],["","43547039950","CYCLOBENZAPR","TAB 5MG","60","Select","Select",""],["","55111018010","TIZANIDINE","TAB 4MG","30","Select","Select",""],["","00781234301","AMPHET\/DEXTR","CAP 15MG ER","30.00","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","63402030430","LATUDA","TAB 40MG","30","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10.2","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","42571012290","LEVOCETIRIZI","TAB 5MG","30","Select","Select",""],["","43547028111","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","68382080510","TRAZODONE","TAB 50MG","60","Select","Select",""],["","13668000905","CITALOPRAM","TAB 10MG","30","Select","Select",""],["","69367013406","GABAPENTIN","TAB 600MG","90","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10.2","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","64980047201","METAXALONE","TAB 800MG","30","Select","Select",""],["","69543013611","TRAMADOL","TAB 50MG","60","Select","Select",""],["","00406117003","NALTREXONE","TAB 50MG","30","Select","Select",""],["","00006003330","BELSOMRA","TAB 10MG","30","Select","Select",""],["","27808003503","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","65862059805","TAMSULOSIN","CAP 0.4MG","14","Select","Select",""],["","31722053960","LEVETIRACETA","TAB 1000MG","60","Select","Select",""],["","35573042030","ATOMOXETINE","CAP 80MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","00603533932","PREDNISONE","TAB 20MG","10","Select","Select",""],["","70010075405","METHOCARBAM","TAB 500MG","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":""}]}]}