{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KIMBERLY   M EASTER","gend":1,"add":"146 WALL STREET","city":"BASSETT","state":"VA","zip":"24055-3675","dob":"1983-09-16","age":"","mstatus":"","insh":4343459,"cliId":"","pno":2762245567,"cno":"","email":"","ename":"","eno":"","pphy":"EDMONDSON, GABRIEL LEE","ppno":5403654469,"pcpadd":"180 Ferrum Mountain Rd, ","pcpcity":"Ferrum","pcpstate":"VA","pcpzip":240882939,"pcpcounty":"","pcpid":"","pcpname":"TRI AREA COMMUNITY HEALTH CENTER AT FERRUM","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"146 WALL STREET","madd2":"","madd3":"","mcity":"BASSETT","mstate":"VA","mzip":"24055-3675","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L23.3","R50.9","J10.1","F31.81","F31.9","E86.0","F11.10","G47.00","E87.6","F11.129","T43.625A","Z88.8","Z72.0","F11.121","Z11.59","R68.89","K59.00","K64.4","R10.30","Z98.891","M54.5","Z91.19","M54.9","V89.9XXA","F60.3","V89.2XXA","Y92.410","Z20.828","G89.29","S61.512A","F15.90","F31.70","Z81.8","Z72.89","F22","Z77.22","Z79.83","Z79.1","S39.82XA","F15.10","F33.2","F32.9","R45.851","F15.24","F11.14","Z79.899","Z91.5","R40.4","T50.904A","T88.7XXA","I95.9","T43.295A","F15.20","F31.5","R00.0","Z32.02","S61.511A","H92.02","F19.10","Z03.818","J02.9","R53.83","M79.671","Z76.0","K59.09","F19.11","R06.02","R05","U07.1","R19.7","R43.9","M54.41","F41.9","N76.0","Z12.4","N39.0","Z11.3","F19.90","F11.23","Z79.891","I10","F19.980","Z20.822","R44.0","Z88.6","Z98.890","Z04.6","F29","F33.3","R74.01","F32.3","R42","W19.XXXA","F11.11","G44.219","R56.9","F43.10","E78.00","Z23","K64.9","M79.672","L98.9","M79.89","M60.272","R22.42","A08.4","S39.012A","F31.62","L97.509","L70.0","F41.1","L02.632"],"date":["2020-01-07","2020-01-24","2020-01-24","2020-01-24","2021-08-03","2020-08-14","2020-12-22","2020-12-22","2020-08-14","2020-08-14","2021-07-29","2021-09-24","2020-12-20","2020-08-14","2020-08-14","2021-01-01","2022-02-14","2020-09-07","2020-09-07","2020-09-07","2020-11-28","2020-11-28","2020-11-30","2020-11-28","2020-12-09","2020-11-29","2020-11-29","2021-08-24","2020-11-30","2020-12-22","2020-11-29","2020-11-29","2020-11-29","2020-11-29","2021-08-24","2020-11-29","2020-11-29","2020-11-29","2020-11-29","2021-08-17","2020-12-15","2021-08-26","2021-08-27","2020-12-09","2020-12-20","2021-07-29","2021-08-27","2020-12-09","2020-12-09","2020-12-09","2020-12-09","2020-12-09","2020-12-17","2021-09-15","2021-07-29","2021-09-24","2020-12-22","2020-12-24","2021-01-19","2021-01-04","2021-01-19","2021-01-19","2021-01-26","2021-02-10","2021-03-02","2021-03-02","2021-04-10","2021-04-10","2021-04-10","2021-04-10","2021-04-10","2021-05-21","2022-02-02","2021-07-07","2021-07-07","2021-08-28","2021-07-20","2021-07-29","2021-07-29","2021-07-29","2021-09-24","2021-07-29","2021-08-24","2021-08-24","2021-08-24","2021-09-24","2021-08-24","2021-08-27","2021-08-25","2021-08-25","2021-08-27","2021-08-29","2021-08-29","2022-03-02","2021-09-24","2021-09-24","2022-02-02","2022-02-02","2022-02-02","2022-02-14","2022-02-15","2022-02-14","2022-02-15","2022-03-17","2022-04-04","2019-02-24","2019-02-25","2019-05-16","2019-06-17","2019-07-18","2019-07-18","2019-09-24"],"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":[["","23155050105","HYDROXYZ","TAB 25MG","16","Select","Select",""],["","12496120403","SUBOXONE","MIS 4-1MG","15","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","20","Select","Select",""],["","68001025320","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","67877025130","TRIAMCINOLON","CRE 0.001","60.00","Select","Select",""],["","65862052830","VENLAFAXINE","CAP 75MG ER","90","Select","Select",""],["","50428231183","MAG","SOL CHERRY","296","Select","Select",""],["","59779030602","CVS","POW ","238","Select","Select",""],["","69097012403","TOPIRAMATE","TAB 100MG","60","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","21","Select","Select",""],["","16729020201","BUSPIRONE","TAB 10MG","60","Select","Select",""],["","66993068030","OLANZAPINE","TAB 2.5MG","30","Select","Select",""],["","59267100003","PFIZER","INJ COVID-19","0.3","Select","Select",""],["","00536106229","STOOL","CAP 100MG","180","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","57896048930","POLYETH","POW 3350 NF","510","Select","Select",""],["","50111043401","TRAZODONE","TAB 100MG","60","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","00406117001","NALTREXONE","TAB 50MG","90","Select","Select",""],["","57896045806","SENNA","TAB 8.6-50MG","30","Select","Select",""],["","49281042050","FLUZONE","INJ 2020-21","0.5","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","30","Select","Select",""],["","43547034006","RISPERIDONE","TAB 0.5MG","30","Select","Select",""],["","70710160901","BACLOFEN","TAB 5MG","60","Select","Select",""],["","42806004801","GUANFACINE","TAB 1MG","30","Select","Select",""],["","13107008305","LORAZEPAM","TAB 0.5MG","4","Select","Select",""],["","42571016242","AMOX\/K","TAB 875-125","20","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","60","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","30","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00054001825","PREDNISONE","TAB 20MG","10","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","9","Select","Select",""],["","00093354556","ATOMOXETINE","CL 40 MG CAP","60","Select","Select",""],["","00093117410","PENICILLN","TAB 500MG","28","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":""}]}]}