{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KARI   E RATCLIFF","gend":1,"add":"6495 HAZEL WOOD DRIVE","city":"DUBLIN                        ","state":"VA","zip":"24084-4203","dob":"1980-07-25","age":"","mstatus":"","insh":4108937,"cliId":"","pno":5403368647,"cno":"","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":"6495 HAZEL WOOD DRIVE","add3":"","madd1":"6495 HAZEL WOOD DRIVE","madd2":"","madd3":"","mcity":"DUBLIN                        ","mstate":"VA","mzip":"24084-4203","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C53.9","Z51.0","C53.8","D63.0","C43.9","D06.7","R52","R53.83","K59.00","Z08","Z85.41","N95.1","F41.8","E04.1","F41.1","R63.5","R53.82","D50.9","R11.0","Z92.89","R23.2","E61.1","Z86.2","Z92.21","Z92.3","N93.9","E32.0","N89.8","E04.2","Z85.9","R89.6","K42.9","M54.5","G89.29","R10.2","C76.0","R93.2","Z85.89","R10.9","R79.89","Z79.899","R93.5","R93.89","F41.9","F32.9","Z79.890","Z01.818","N76.1","D26.0","N99.2","R09.89","Z20.822","I95.9","Z20.828","K62.5","N89.5","K59.09","Z83.71","R12","N95.2","Z01.812","Z12.11","E55.9","K43.9","R10.84","K44.9","E66.9","Z68.41","D50.0","N18.9","R06.02","K42.0","R50.9","R55","U07.1","M79.10","J34.89","R05.9","R73.9","K46.9","N13.30","R91.8","Z78.0","R07.89","R07.9","G47.00","D64.9","M25.561","I10","M62.838","R53.1","D72.819","I08.1","Z53.20","M54.30","M54.31","R32","R30.0","Z32.02","R87.614","D62","R65.10","R50.81","D06.9","N39.3","N88.8","R06.00","R94.31","Z03.89","C54.1","E07.9","Z12.4","M51.36","Z45.2","N93.8","Z51.11","K04.7","K08.89","R60.0"],"date":["2021-12-21","2020-02-05","2021-07-12","2020-01-16","2020-01-17","2020-01-29","2021-12-21","2021-03-12","2020-08-13","2022-02-07","2022-02-07","2020-06-08","2021-07-12","2020-09-22","2020-08-13","2021-12-21","2021-03-12","2020-04-22","2021-10-22","2020-04-22","2020-04-22","2020-04-22","2020-04-22","2020-10-02","2020-10-02","2020-10-08","2020-05-19","2020-10-02","2020-07-07","2020-07-07","2020-07-23","2021-09-21","2020-08-20","2021-09-16","2020-08-21","2020-08-20","2020-08-20","2020-08-20","2021-03-12","2020-08-25","2021-10-22","2020-09-30","2020-10-02","2020-10-02","2020-10-02","2020-10-02","2020-10-03","2020-10-08","2020-10-08","2020-10-08","2021-01-07","2021-08-05","2021-03-12","2021-12-21","2021-07-12","2022-02-07","2021-06-04","2021-06-04","2021-06-04","2021-07-12","2021-07-16","2021-12-21","2021-12-21","2021-09-21","2021-07-21","2021-07-21","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-10-04","2021-09-21","2021-10-04","2021-10-22","2021-10-22","2021-10-04","2021-10-04","2021-10-04","2021-10-22","2021-10-22","2021-11-14","2021-11-14","2022-02-07","2019-01-04","2019-01-04","2019-11-26","2019-11-27","2019-11-26","2019-11-26","2019-11-26","2019-05-10","2019-05-10","2019-05-10","2019-06-18","2019-08-05","2019-08-05","2019-09-16","2019-09-16","2019-10-30","2019-10-22","2019-10-26","2019-10-24","2019-10-23","2019-10-24","2019-10-24","2019-12-12","2019-10-24","2019-10-24","2019-10-24","2019-10-30","2019-11-07","2019-11-26","2019-12-02","2019-11-25","2019-11-27","2019-12-02","2019-12-28","2019-12-28","2019-12-28"],"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":[["","57237007710","ONDANSETRON","TAB 4MG ODT","10","Select","Select",""],["","40985027288","VITAMIN","TAB 5000UNIT","30","Select","Select",""],["","00781712983","ESTRADIOL","DIS 0.025MG","8","Select","Select",""],["","65162080710","PROGESTERONE","CAP 100MG","30","Select","Select",""],["","00093216568","NALOXONE","SPR ","2","Select","Select",""],["","42858000201","OXYCODONE","TAB 10MG","60","Select","Select",""],["","47781023005","OXYCOD\/APAP","TAB 10-325MG","150","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","60","Select","Select",""],["","00046087221","PREMARIN","CRE 0.625MG","30","Select","Select",""],["","70069000510","CYANOCOBALAM","INJ 1000MCG","2","Select","Select",""],["","00536117201","ACETAMIN","TAB 500MG","30","Select","Select",""],["","67877032005","IBUPROFEN","TAB 600MG","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","11917010573","PROBIOTIC","CAP SUPER","30","Select","Select",""],["","51224012230","AZITHROMYCIN","TAB 500MG","7","Select","Select",""],["","00536124801","STIMULANT","TAB 8.6-50MG","25","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","14","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","5","Select","Select",""],["","55111068301","IBU","TAB 600MG","30","Select","Select",""],["","10135013805","DOCUSATE","CAP 240MG","60","Select","Select",""],["","00591079401","DICYCLOMINE","CAP 10MG","120","Select","Select",""],["","00143993905","AMOXICILLIN","CAP 500MG","14","Select","Select",""],["","08290329622","INSULIN","MIS 1ML\/25G","4","Select","Select",""],["","51991070510","ALPRAZOLAM","TAB 0.5MG","60","Select","Select",""],["","42571016142","AMOX\/K","TAB 500-125","14","Select","Select",""],["","54838000180","FERROUS","ELX 220\/5ML","250","Select","Select",""],["","69543038330","OLANZAPINE","TAB 10MG","24","Select","Select",""],["","16729020016","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","63868026401","SENNA-S","TAB 8.6-50MG","60","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","36","Select","Select",""],["","49100036374","CULTURELLE","CAP IMMUNITY","7","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","42571025201","CLINDAMYCIN","CAP 300MG","42","Select","Select",""],["","63868034801","FIBER","CAP 0.52GM","60","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":""}]}]}