{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBORAH   S BEER","gend":1,"add":"9278 RAPPAHANOCK TRAIL","city":"ASHLAND                       ","state":"VA","zip":"23005-9998","dob":"1977-02-17","age":"","mstatus":"","insh":6550663,"cliId":"","pno":8045649521,"cno":"","email":"","ename":"","eno":"","pphy":"DISLER, ROBIN SHAYE","ppno":8042827857,"pcpadd":"7001 Forest Ave,Ste 2500","pcpcity":"Richmond                      ","pcpstate":"VA","pcpzip":232301726,"pcpcounty":"","pcpid":"","pcpname":"WEST END INTERNAL MEDICINE","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"CENTRAL","aligned":"","ano":"","add2":"9278 RAPPAHANOCK TRAIL","add3":"","madd1":"9278 RAPPAHANOCK TRAIL","madd2":"UNIT 1","madd3":"","mcity":"ASHLAND                       ","mstate":"VA","mzip":"23005-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J01.00","M54.12","M54.2","M25.511","F17.210","M47.812","G43.719","M47.816","G47.00","Z72.0","M48.02","M50.30","F33.1","F17.200","G43.829","M47.22","R10.9","M51.36","F33.42","F41.9","D72.829","G89.29","Z68.25","D72.89","F11.90","M06.9","M62.838","M06.09","Z68.23","R87.810","R87.610","K59.00","Z87.891","B37.3","K59.09","F11.20","K21.9","R12","T40.2X5A","R10.84","Z68.24","Z01.812","Z20.828","Z83.71","K29.70","K31.9","K20.90","K21.00","K64.8","F17.290","M19.90","R68.83","R61","D46.4","K58.9","M47.817","G43.709","F41.1","M54.81","M79.18","Z68.22","D64.9","D51.9","D52.9","R22.31","G43.909","Z79.51","Z79.891","Z79.3","Z79.1","Z79.899","F33.2","R20.2","Z12.31","Z91.89","Z68.20","Z01.419","Z12.4","Z11.51","Z12.39","D51.0","R00.2","I49.9","R07.9","R06.02","R25.2","M79.641","M79.642","M79.671","M79.672","K62.89","Z88.1","Z88.2","Z88.5","Z88.6","Z88.8","K62.5","R00.0","F05","F22","F99","R44.2","F41.8","R03.0","Z20.822","Z32.02","Z91.018","Z80.8","Z82.49","F29","A41.9","W19.XXXA","D69.59","I95.0","A09","E87.1","F31.5","D50.9","F23","R41.82","K51.90","R39.89","F31.64","R65.10","I95.89","F11.150","F12.150","Z81.8","F11.188","F12.180","F39","K52.9","R50.9","K63.89","R19.7","K50.10","J90","K63.3","R18.8","E86.0","E03.9","F31.9","D69.6","I95.9","R93.3","K50.00","R14.0","K50.90","R13.10","R63.4","K52.89","Z09","Z68.1","Z30.09","Z30.017"],"date":["2020-03-12","2021-06-17","2021-01-12","2021-11-22","2020-02-17","2020-06-03","2021-12-14","2021-03-15","2020-03-09","2021-11-01","2021-07-23","2021-01-12","2021-12-13","2020-03-12","2021-12-14","2020-05-26","2021-10-29","2020-07-07","2020-07-07","2021-11-01","2021-12-10","2020-07-07","2020-07-07","2021-10-04","2021-03-15","2020-08-11","2021-09-19","2021-12-21","2020-08-17","2020-09-01","2020-09-01","2021-11-29","2021-11-29","2020-09-29","2021-04-29","2020-10-02","2021-04-29","2020-10-02","2020-10-02","2021-10-29","2021-01-12","2020-11-02","2020-11-02","2020-11-06","2021-12-10","2021-11-03","2021-12-08","2020-11-06","2020-11-06","2021-11-29","2021-10-29","2021-10-04","2021-10-04","2020-12-14","2021-10-29","2021-01-26","2021-12-27","2021-12-13","2021-12-14","2021-09-13","2021-05-10","2021-10-04","2021-10-04","2021-10-04","2021-06-17","2021-10-29","2021-06-17","2021-06-17","2021-10-29","2021-10-29","2021-11-29","2021-07-09","2021-07-09","2021-08-03","2021-07-09","2021-10-19","2021-08-17","2021-08-17","2021-08-17","2021-08-17","2021-11-29","2021-09-16","2021-09-16","2021-09-16","2021-09-16","2021-09-19","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-10-27","2021-10-31","2021-10-31","2021-10-31","2021-10-31","2021-10-27","2021-10-29","2021-11-29","2021-10-31","2021-10-31","2021-12-06","2021-10-31","2021-10-31","2021-10-31","2021-12-03","2021-12-30","2021-10-31","2021-10-31","2021-10-31","2021-11-27","2021-12-01","2021-11-29","2021-12-04","2021-11-29","2021-12-04","2021-12-03","2021-11-29","2021-12-03","2021-11-30","2021-11-02","2021-11-03","2021-11-04","2021-11-24","2021-12-03","2021-12-15","2021-11-29","2021-11-29","2021-11-29","2021-11-29","2021-11-29","2021-12-07","2021-12-15","2021-11-29","2021-12-07","2021-12-10","2021-12-09","2021-12-04","2021-12-08","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2021-12-06","2021-12-06","2021-12-10","2021-12-04","2021-12-08","2021-12-08","2021-12-08","2021-12-08","2021-12-10","2021-12-15","2021-12-21","2021-12-27","2021-12-30"],"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":[["","00378668910","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","69680011225","CYANOCOBALAM","INJ 1000MCG","1","Select","Select",""],["","00115180401","HYDROXYZ","CAP 50MG","42","Select","Select",""],["","00023392102","BOTOX","INJ 200UNIT","1","Select","Select",""],["","70436001102","BUPROPN","TAB 300MG XL","21","Select","Select",""],["","00143312601","DICYCLOMINE","CAP 10MG","90","Select","Select",""],["","30768004069","FOLATE","TAB 400MCG","30","Select","Select",""],["","69097012403","TOPIRAMATE","TAB 100MG","60","Select","Select",""],["","00078051105","TEGRETOL-XR","TAB 200MG","60","Select","Select",""],["","59651024601","MIDODRINE","TAB 2.5MG","90","Select","Select",""],["","00603371834","FROVATRIPTAN","TAB 2.5MG","6","Select","Select",""],["","64380076921","PEG-3350\/KCL","SOL \/SODIUM","4,000.00","Select","Select",""],["","55513084301","AIMOVIG","INJ 140MG\/ML","1","Select","Select",""],["","68382071782","ZOLMITRIPTAN","TAB 5MG ODT","6","Select","Select",""],["","50428050854","CVS","PAK ","10","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","8","Select","Select",""],["","50428038612","ACETAMINOPHN","TAB 500MG","28","Select","Select",""],["","13107008305","LORAZEPAM","TAB 0.5MG","60","Select","Select",""],["","16571068101","CARBAMAZEPIN","TAB 200MG ER","60","Select","Select",""],["","43386035801","HYDROCO\/APAP","TAB 10-325MG","90","Select","Select",""],["","00093216568","NALOXONE","SPR 4MG","2","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":""}]}]}