{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BARBARA   F FINNEY","gend":1,"add":"2371   APPALACHIAN DRIVE                                    ","city":"MARTINSVILLE                  ","state":"VA","zip":"24112-7176","dob":"1972-06-19","age":"","mstatus":"","insh":10055776,"cliId":"","pno":2767326765,"cno":2762014600,"email":"","ename":"","eno":"","pphy":"FATADE, AYOKUNLE O                                          ","ppno":"","pcpadd":"1 E Market St Ste B1","pcpcity":"Martinsville                  ","pcpstate":"VA","pcpzip":241123747,"pcpcounty":"","pcpid":"P0060085","pcpname":"FATADE HEALTH AND MEDICAL CENTER PC","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"ROANOKE\/ ALLEGHANY","aligned":"","ano":"","add2":"APT A                                                       ","add3":"","madd1":"2371   APPALACHIAN DRIVE                                    ","madd2":"APT A                                                       ","madd3":"","mcity":"MARTINSVILLE                  ","mstate":"VA","mzip":"24112-7176","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.5","M54.6","M54.2","R51","X50.9XXA","Y92.009","Z87.891","R07.89","H11.31","H10.9","J01.90","R05","R11.2","J18.0","D64.9","J40","R06.02","Z79.899","M48.02","M25.511","M79.601","M50.322","M75.41","M54.12","M24.811","M50.20","M50.30","M47.812","S39.012A","S39.92XA","X58.XXXA","M25.562","G89.29","J45.909","R21","E87.6","M75.121","M67.813","S43.431A","M62.838","S46.111A","G89.18","S46.211A","M75.21","K04.7","K03.81","S02.5XXA","K08.89","Z98.818","Z47.89","M62.81","M43.6","M25.611","Z00.00","S16.1XXA","S19.9XXA","V49.50XA","Y92.410","Y99.9","Z98.890","M25.552","M54.16","R10.2","M51.36","M47.26","M47.816","M48.061","M51.16","M51.26","R20.0","M79.642","S69.92XA","S60.221A","S69.91XA","W22.8XXA","Y92.9","M79.641","W19.XXXA","W01.0XXA","Y93.01","Y92.512","I10","M79.621","Z13.6","M43.16","K21.9","Z88.0","F20.9","Z98.1","Z09","M43.26","M75.51","M16.0","F06.30","G43.109","G89.4","V49.49XA","Y99.8","M54.41","M54.42","M62.830","H04.123","H52.4","H52.223","M67.911","M85.611","M62.511","M54.9","M75.101","Z01.818","Z48.89","R79.89","E55.9","Z13.9","S43.421D","J06.9","Z88.8","Z20.822","R07.9","R06.83","M79.18","S33.5XXA","M54.32","L03.90","T63.461A"],"date":["2021-09-29","2019-02-23","2020-03-14","2019-02-23","2019-02-23","2019-02-23","2020-10-20","2019-02-23","2019-03-02","2019-03-02","2019-03-02","2021-08-11","2019-04-02","2019-03-02","2019-03-02","2019-03-02","2019-03-02","2021-10-28","2019-03-26","2021-09-20","2019-03-05","2019-03-05","2019-05-15","2019-03-26","2021-01-25","2019-03-26","2019-03-26","2019-03-26","2020-10-03","2020-10-03","2021-10-28","2021-10-28","2020-01-10","2020-10-20","2021-11-11","2019-04-02","2021-03-29","2019-04-08","2019-06-10","2019-05-19","2019-06-10","2021-03-29","2019-06-10","2019-06-10","2019-06-25","2019-06-25","2019-06-25","2019-06-25","2019-06-25","2021-09-20","2021-09-20","2019-07-25","2019-07-31","2019-07-31","2019-10-04","2019-10-04","2019-10-04","2020-10-03","2021-10-28","2021-03-29","2020-01-10","2021-02-24","2020-01-10","2020-01-23","2020-03-04","2020-03-24","2020-06-17","2020-03-04","2020-02-13","2021-10-28","2020-02-21","2020-02-21","2020-02-21","2020-02-21","2020-02-21","2020-02-21","2020-03-14","2020-03-14","2020-03-14","2020-03-14","2020-03-14","2021-08-11","2020-03-14","2020-05-22","2020-05-28","2021-09-29","2021-10-28","2020-05-28","2021-10-28","2020-06-17","2021-05-26","2020-07-20","2020-08-05","2021-09-29","2021-08-03","2021-08-03","2020-10-03","2020-10-03","2020-10-20","2020-10-20","2021-09-29","2020-11-19","2020-11-19","2020-11-19","2021-01-08","2021-01-25","2021-01-25","2021-05-26","2021-02-24","2021-03-25","2021-02-24","2021-03-02","2021-03-02","2021-03-02","2021-09-20","2021-08-11","2021-10-28","2021-08-11","2021-08-11","2021-08-31","2021-11-16","2021-10-28","2021-10-28","2021-11-11","2021-11-11"],"priorHcc":["","","","","","","","","","","","","","","","","",null,"","","","","","","","","","","","",null,null,"","",null,"","","","","","","","","","","","","","","","","","","","","","","",null,"","","","","","","","","","",null,"","","","","","","","","","","","","","","","",null,"",null,"","","","","","","","","","","","","","","","","","","","","","","","","","","",null,"","","",null,null,null,null,null]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","00378668999","PANTOPRAZOLE","40MG","90","Select","Select",""],["","00406055201","OXYCODONE","5MG","60","Select","Select",""],["","00591352530","LIDOCAINE","5%","90","Select","Select",""],["","52817033010","CYCLOBENZAPR","5MG","45","Select","Select",""],["","52747047570","NOREL","4-10-325","60","Select","Select",""],["","00904679480","ASPIRIN","81MG","28","Select","Select",""],["","00093031401","KETOROLAC","10MG","20","Select","Select",""],["","71093014005","METHOCARBAM","500MG","20","Select","Select",""],["","53489011905","DOXYCYCL","100MG","10","Select","Select",""],["","00378064110","PREDNISONE","10MG","20","Select","Select",""],["","67877057305","BENZONATATE","100MG","15","Select","Select",""],["","37000045502","PRILOSEC","20MG","84","Select","Select",""],["","16571020150","DICLOFENAC","75MG DR","60","Select","Select",""],["","00406012305","HYDROCO\/APAP","5-325MG","60","Select","Select",""],["","60505025203","TIZANIDINE","4MG","30","Select","Select",""],["","65862039010","ONDANSETRON","4MG ODT","12","Select","Select",""],["","65162068090","PROMETHAZINE","DM","240","Select","Select",""],["","69097014260","ALBUTEROL","HFA","6.7","Select","Select",""],["","59746000103","METHYLPRED","4MG","21","Select","Select",""],["","65162019050","NAPROXEN","500MG","30","Select","Select",""],["","00904645780","DOK","100MG","30","Select","Select",""],["","67877022210","GABAPENTIN","100MG","270","Select","Select",""],["","00781808926","AZITHROMYCIN","250MG","6","Select","Select",""],["","43386048024","ORPHENADRINE","100MG ER","20","Select","Select",""],["","00904671980","ACETAMINOPHEN","B 325","30","Select","Select",""],["","00904672580","SENNA","8.6MG","30","Select","Select",""],["","70700026390","LANSOPRAZOLE","30MG DR","30","Select","Select",""],["","00781185220","AMOX\/K","875-125","20","Select","Select",""],["","60505082901","FLUTICASONE","50MCG","16","Select","Select",""],["","00378668977","PANTOPRAZOLE ","TAB 40MG","90","Select","Select",""],["","70700026390","LANSOPRAZOLE ","CAP 30MG DR","30","Select","Select",""],["","00406055201","OXYCODONE ","TAB 5MG","60","Select","Select",""],["","16571020150","DICLOFENAC ","TAB 75MG DR","60","Select","Select",""],["","52747047570","NOREL ","TAB 4-10-325","30","Select","Select",""],["","53489011905","DOXYCYCL ","CAP 100MG","10","Select","Select",""],["","67877057305","BENZONATATE ","CAP 100MG","15","Select","Select",""],["","00591352530","LIDOCAINE ","PAD 0.05","90","Select","Select",""],["","52817033010","CYCLOBENZAPR ","TAB 5MG","45","Select","Select",""],["","00904679480","ASPIRIN ","CHW 81MG","28","Select","Select",""],["","00093031401","KETOROLAC ","TAB 10MG","20","Select","Select",""],["","71093014005","METHOCARBAM ","TAB 500MG","20","Select","Select",""],["","00378064110","PREDNISONE ","TAB 10MG","20","Select","Select",""],["","00093101042","MUPIROCIN ","OIN 0.02","22","Select","Select",""],["","16571040250","CETIRIZINE ","TAB 10MG","10","Select","Select",""],["","37000045502","PRILOSEC ","TAB 20MG","84","Select","Select",""],["","00406012305","HYDROCO\/APAP ","TAB 5-325MG","60","Select","Select",""],["","60505025203","TIZANIDINE ","TAB 4MG","30","Select","Select",""],["","65862039010","ONDANSETRON ","TAB 4MG ODT","12","Select","Select",""],["","65162068090","PROMETHAZINE ","SOL DM","240","Select","Select",""],["","69097014260","ALBUTEROL ","AER HFA","6.7","Select","Select",""],["","59746000103","METHYLPRED ","TAB 4MG","21","Select","Select",""],["","65162019050","NAPROXEN ","TAB 500MG","30","Select","Select",""],["","00904645780","DOK ","CAP 100MG","30","Select","Select",""],["","67877022210","GABAPENTIN ","CAP 100MG","270","Select","Select",""],["","00781808926","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","43386048024","ORPHENADRINE ","TAB 100MG ER","20","Select","Select",""],["","00904671980","ACETAMINOPHEN ","TA B 325","30","Select","Select",""],["","00904672580","SENNA ","TAB 8.6MG","30","Select","Select",""],["","00781185220","AMOX\/K ","TAB 875-125","20","Select","Select",""],["","60505082901","FLUTICASONE ","SPR 50MCG","16","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}