{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VICKIE   J TAYLOR","gend":1,"add":"22 POND DR","city":"CASTLEWOOD","state":"VA","zip":"24224-5784","dob":"1964-02-20","age":"","mstatus":"","insh":10061122,"cliId":"","pno":2602439793,"cno":"               ","email":"","ename":"","eno":"","pphy":"ABROKWAH, JAMES","ppno":2768351122,"pcpadd":"163 Number Ten St, ","pcpcity":"Clinchco","pcpstate":"VA","pcpzip":242268694,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"SOUTHWEST","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"PO Box 262","madd2":"                                                            ","madd3":"","mcity":"Castlewood","mstate":"VA","mzip":"24224-0262","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R07.9","Z86.79","N17.9","I95.9","F17.210","J44.9","G89.4","F41.8","I10","E78.5","I25.10","I73.9","I05.1","I05.8","M54.17","F34.1","E11.9","C50.912","K21.9","C50.919","C50.911","C50.011","C50.012","F41.9","E86.0","R11.0","R19.7","Z87.39","R05","G47.00","E78.2","Z13.29","R73.09","N63.20","Z51.11","Z71.9","S33.5XXA","C50.812","R53.1","C78.00","Z79.4","Z79.899","F11.90","Z17.0","G89.3","Z12.31","R92.8","N63.10","R07.89","R06.02","M79.602","F31.9","I25.2","G89.29","Z85.3","Z88.1","Z79.82","G43.909","R59.0","M79.7","F41.1","Z72.0","B37.0","D51.3","Z95.828","I34.0","I34.8","Z79.811","Z90.49","I21.4","T82.858A","I42.0","E11.51","E66.9","T82.855A","I25.5","Z95.5","R00.0","R91.8","N64.9","N63.25","N63.11","N63.13","N63.15","R91.1","Z79.891","L27.1","M19.90","M54.5","I25.119","Z99.81","T82.858D","Z98.61","Z01.89","J98.9","G44.83","L73.2","J44.1","Z45.2","I51.89","N63.0","N64.89","Z03.818","Z51.12","R52","M47.812","G25.81","E78.49","R74.8","E11.42","Z86.14","Z86.718","R20.9","A09","R53.81","Z79.1","K52.9","F17.290","M25.50","R30.0","Z91.81","F41.0","Z79.84","M13.0","R57.1","E11.22","I13.10","N28.9","J84.10","J40","C77.1","C80.1"],"date":["2020-07-09","2019-10-04","2019-12-19","2019-12-19","2021-03-18","2021-04-12","2020-09-02","2019-12-19","2021-03-10","2020-09-04","2021-04-16","2019-10-04","2019-10-04","2019-10-04","2021-05-07","2021-01-07","2021-05-07","2021-05-14","2021-03-18","2021-04-01","2021-05-14","2021-04-16","2021-04-16","2021-04-01","2020-10-01","2019-12-19","2020-02-19","2019-12-19","2019-12-19","2021-05-07","2021-03-10","2021-03-10","2021-03-10","2020-07-22","2021-04-22","2020-09-03","2020-10-13","2020-10-13","2020-10-13","2020-11-18","2020-11-18","2021-04-22","2020-11-20","2021-04-20","2021-04-16","2019-05-17","2020-06-30","2020-09-04","2020-07-09","2020-07-09","2020-07-09","2020-10-06","2020-09-02","2020-07-09","2020-07-27","2020-07-09","2020-09-02","2020-10-06","2020-10-06","2020-09-02","2020-09-02","2020-09-02","2020-12-18","2021-04-01","2021-04-01","2021-04-22","2021-04-22","2021-04-20","2021-04-20","2020-05-19","2019-10-04","2019-12-19","2019-12-19","2019-10-04","2019-10-05","2019-10-05","2019-10-05","2020-02-19","2020-08-10","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2020-09-04","2020-09-02","2020-10-06","2020-10-06","2020-10-06","2021-03-09","2019-06-06","2019-10-05","2019-10-05","2020-09-02","2020-09-04","2020-12-02","2020-12-02","2020-12-02","2021-02-26","2021-04-22","2020-07-27","2020-08-03","2020-08-28","2020-11-18","2021-04-16","2019-01-30","2019-04-30","2019-09-10","2019-10-03","2019-12-19","2019-10-03","2019-10-03","2019-12-19","2020-02-19","2020-02-19","2020-02-19","2020-02-19","2020-04-16","2020-10-01","2020-10-01","2020-10-01","2019-06-06","2019-06-06","2019-10-09","2019-12-19","2019-12-19","2019-12-19","2019-12-19","2020-07-21","2020-09-04","2020-09-04","2020-09-04"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"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":[["","13107008405","LORAZEPAM ","TAB 1MG","100","Select","Select",""],["","76385011050","CARVEDILOL ","TAB 3.125MG","180","Select","Select",""],["","10702000201","PROMETHAZINE ","TAB 12.5MG","60","Select","Select",""],["","65162019050","NAPROXEN ","TAB 500MG","60","Select","Select",""],["","71093011105","GABAPENTIN ","TAB 600MG","90","Select","Select",""],["","00115681110","BUPROPN ","TAB 150MG XL","30","Select","Select",""],["","13668000810","ZOLPIDEM ","TAB 10MG","15","Select","Select",""],["","67877024201","QUETIAPINE ","TAB 25MG","90","Select","Select",""],["","43547035611","LISINOPRIL ","TAB 40MG","30","Select","Select",""],["","67877056310","METFORMIN ","TAB 1000MG","60","Select","Select",""],["","55111012405","ATORVASTATIN ","TAB 80MG","30","Select","Select",""],["","65162083366","DICLOFENAC ","GEL 0.01","100","Select","Select",""],["","00228300350","CLONAZEPAM ","TAB 0.5MG","90","Select","Select",""],["","10702019010","HYDROCO\/APAP ","TAB 7.5-325","60","Select","Select",""],["","63304044990","FENOFIBRATE ","TAB 145MG","30","Select","Select",""],["","47469000928","OMEGA-3 ","CAP 1000MG","60","Select","Select",""],["","00088221905","LANTUS ","INJ 100\/ML","15","Select","Select",""],["","00093645198","ESOMEPRA ","CAP 40MG DR","30","Select","Select",""],["","68180071160","CEFDINIR ","CAP 300MG","20","Select","Select",""],["","59762330403","NITROGLYCERN ","SUB 0.4MG","25","Select","Select",""],["","32671000534","LITETOUCH ","MIS 31GX8MM","100","Select","Select",""],["","00186077760","BRILINTA ","TAB 90MG","24","Select","Select",""],["","62175026137","NIFEDIPINE ","TAB 60MG ER","30","Select","Select",""],["","69618004610","ASPIRIN ","TAB 81MG EC","30","Select","Select",""],["","00085113204","PROVENTIL ","AER HFA","6.7","Select","Select",""],["","00093540189","OMEGA-3-ACID ","CAP 1GM","60","Select","Select",""],["","00603548421","PROPRANOLOL ","TAB 40MG","60","Select","Select",""],["","00299392001","CETAPHIL ","CRE ","453","Select","Select",""],["","55111068205","IBU ","TAB 400MG","120","Select","Select",""],["","42858080101","MORPHINE ","TAB 15MG ER","56","Select","Select",""],["","68462052935","CLOBETASOL ","CRE 0.0005","30","Select","Select",""],["","67405060301","FLUCONAZOLE ","TAB 150MG","1","Select","Select",""],["","00487020160","IPRATROPIUM\/ ","SOL ALBUTER","180","Select","Select",""],["","00006027731","JANUVIA ","TAB 100MG","90","Select","Select",""],["","42858000401","OXYCODONE ","TAB 20MG","42","Select","Select",""],["","65862085901","FAMOTIDINE ","TAB 20MG","30","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","Select","Select",""],["","00193731150","CONTOUR ","TES NEXT","50","Select","Select",""],["","59762374302","CLINDAMYCIN ","GEL 0.01","30","Select","Select",""],["","59746017310","PREDNISONE ","TAB 10MG","20","Select","Select",""],["","62135098550","DOXYCYCL ","CAP 100MG","20","Select","Select",""],["","45802008801","ALBUTEROL ","AER HFA","8.5","Select","Select",""],["","00591079501","DICYCLOMINE ","TAB 20MG","60","Select","Select",""],["","67877031905","IBUPROFEN ","TAB 400MG","120","Select","Select",""],["","46122012078","ESSENTL ","TAB DAILY","60","Select","Select",""],["","00904404360","FISH ","CAP 1000MG","60","Select","Select",""],["","59762045001","COLESTIPOL ","TAB 1GM","120","Select","Select",""],["","51991075933","LETROZOLE ","TAB 2.5MG","30","Select","Select",""],["","00536589588","NICOTINE ","DIS 14MG\/24H","28","Select","Select",""],["","43547039811","HYDROCHLOROT ","TAB 50MG","30","Select","Select",""],["","65862039110","ONDANSETRON ","TAB 8MG ODT","90","Select","Select",""],["","23155050001","HYDROXYZ ","TAB 10MG","90","Select","Select",""],["","47781019605","OXYCOD\/APAP ","TAB 5-325MG","60","Select","Select",""],["","00193658621","MICROLET ","MIS LANCETS","100","Select","Select",""],["","00121081016","NYSTATIN ","SUS 100000","140","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","00054418425","DEXAMETHASON ","TAB 4MG","10","Select","Select",""],["","00113030603","CLEARLAX ","POW ","510","Select","Select",""],["","69315011710","FUROSEMIDE ","TAB 40MG","30","Select","Select",""],["","00378456077","POT  CHLORIDE","TAB 8MEQ ER","30","Select","Select",""],["","66685100200","AMOX\/K ","TAB 500-125","60","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":[[["Yes","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","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":""}]}]}