{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JESSICA   M SHRADER","gend":1,"add":"529 STONES DAIRY ROAD","city":"MARTINSVILLE                  ","state":"VA","zip":"24112-7221","dob":"1993-12-07","age":"","mstatus":"","insh":6836667,"cliId":"","pno":5404163253,"cno":5402696153,"email":"","ename":"","eno":"","pphy":"CHEEK, KIMBERLY M","ppno":5402457950,"pcpadd":"201 Lew Dewitt Blvd,","pcpcity":"Waynesboro                    ","pcpstate":"VA","pcpzip":229801663,"pcpcounty":"","pcpid":"","pcpname":"AUGUSTA HEALTH INTERNAL MEDICINE WAYNESBORO","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"529 STONES DAIRY ROAD","add3":"","madd1":"50 Freeport Ln","madd2":"APT 12","madd3":"","mcity":"Staunton                      ","mstate":"VA","mzip":"24401-8437","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.33","R51","E86.0","E87.6","R10.9","R63.8","R82.90","R42","D69.6","Z98.84","R10.13","R11.2","R68.89","E46","Z68.41","R10.84","R19.7","Z90.49","Z68.37","K28.9","K25.9","E44.0","Z68.43","E51.9","D61.818","I10","Z91.19","E83.42","E87.8","Z79.899","Z82.3","Z82.49","K90.9","Z01.818","K29.50","K25.4","E83.39","E53.8","Z32.01","Z11.59","Z20.828","O20.0","O26.891","R10.33","Z3A.01","O23.591","O99.211","O34.219","O26.841","Z12.4","E66.9","Z3A.09","Z68.33","Z34.90","O26.849","O20.9","Z3A.14","O46.92","N93.9","Z00.00","Z3A.13","O20.8","Z39.1","Z34.82","Z34.83","Z3A.15","O99.212","Z36.89","Z34.03","O36.8190","I82.409","L53.9","R20.9","R22.42","Z23","Z36.85","O26.893","R51.9","O36.8130","Z3A.36","O99.891","H53.8","H53.149","R60.0","O99.843","O47.1","Z04.3","Z3A.37","O34.211","N85.8","O75.82","Z3A.38","Z37.0","O99.844","Z20.822","Z03.71","K56.7","R11.0","Z87.11","Z98.891","Z71.3","K92.9","B96.81","E55.9","Z01.812","E66.01","Z79.84","R73.03","F32.9","R10.30","R82.2"],"date":["2020-10-09","2020-01-26","2020-05-20","2020-05-22","2021-05-24","2020-01-26","2020-01-26","2020-02-18","2020-05-24","2022-01-01","2022-01-02","2020-05-24","2020-12-23","2020-05-24","2020-04-02","2020-05-24","2020-05-10","2022-01-01","2020-05-19","2020-05-23","2020-05-20","2020-05-20","2020-05-20","2020-05-20","2020-05-20","2020-05-20","2020-05-20","2020-05-24","2020-05-20","2021-05-24","2020-05-20","2020-11-17","2020-05-20","2020-05-20","2020-05-22","2020-05-22","2020-05-24","2020-05-24","2020-11-03","2020-10-13","2020-10-13","2020-10-24","2020-10-24","2020-10-24","2020-11-03","2020-10-24","2020-12-16","2021-06-06","2020-11-17","2020-11-03","2020-12-16","2020-11-17","2020-11-17","2021-06-14","2020-11-17","2020-12-15","2020-12-15","2020-12-15","2020-12-15","2020-12-16","2020-12-16","2020-12-16","2020-12-18","2020-12-18","2021-06-06","2020-12-23","2020-12-23","2021-05-26","2021-04-01","2021-06-01","2021-04-26","2021-04-26","2021-04-26","2021-04-26","2021-05-21","2021-05-21","2021-05-26","2021-05-26","2021-05-24","2021-05-26","2021-05-24","2021-05-24","2021-05-24","2021-05-24","2021-05-26","2021-05-28","2021-05-28","2021-06-06","2021-06-06","2021-06-06","2021-06-06","2021-06-06","2021-06-06","2021-06-06","2021-06-06","2021-06-06","2022-01-01","2022-01-01","2022-01-01","2022-01-01","2019-08-30","2019-09-19","2019-09-19","2019-11-18","2019-11-06","2019-11-18","2019-11-18","2019-12-06","2019-11-18","2019-12-06","2019-12-06"],"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":[["","59651000205","OMEPRAZOLE","CAP 20MG","28","Select","Select",""],["","00904667840","OXYCODONE","SOL 5MG\/5ML","75","Select","Select",""],["","00904645760","DOK","CAP 100MG","7","Select","Select",""],["","00363010412","PAIN","TAB 325MG","100","Select","Select",""],["","59651036205","IBUPROFEN","TAB 800MG","12","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","12","Select","Select",""],["","72647033104","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00168000215","TRIAMCINOLON","CRE 0.005","15","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","51991018142","FERROCITE","TAB 324MG","60","Select","Select",""],["","11917007923","VITAMIN","TAB 100MG","30","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","59762500801","MISOPROSTOL","TAB 200MCG","120","Select","Select",""],["","00378668999","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","11917013956","FOLIC","TAB 400MCG","14","Select","Select",""],["","37000045502","PRILOSEC","TAB 20MG","60","Select","Select",""],["","00536408501","PRENATAL","TAB 28-0.8MG","30","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","28","Select","Select",""],["","54629075002","MULTI-VIT\/","TAB MINERALS","60","Select","Select",""],["","11917013972","B-12","TAB 500MCG","60","Select","Select",""],["","11917014595","CALC","TAB 250-200","60","Select","Select",""],["","49348030539","MILK","SUS 1200\/15","355","Select","Select",""],["","53746021805","METFORMIN","TAB 500MG","60","Select","Select",""],["","16714066202","GABAPENTIN","CAP 300MG","42","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","51672128902","NYSTATIN","CRE 100000","30","Select","Select",""],["","65862022660","CLARITHROMYC","TAB 500MG","28","Select","Select",""],["","65862037401","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","31604002676","D3","CAP 1000UNIT","60","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","56","Select","Select",""],["","45802020326","ACETAMINOPHN","SUS 160\/5ML","354","Select","Select",""],["","50111043302","TRAZODONE","TAB 50MG","30","Select","Select",""],["","00527174330","PHENTERMINE","CAP 37.5MG","30","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":""}]}]}