{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TAYLOR   J RUBLE","gend":1,"add":"585 BRUSHFORK ROAD                                          ","city":"FALLS MILLS                   ","state":"VA","zip":"24613-9506","dob":"1997-03-08","age":"","mstatus":"","insh":10162056,"cliId":"","pno":2762453949,"cno":3048886439,"email":"","ename":"","eno":"","pphy":"BOWLING, LADONNA RENAE                                      ","ppno":"","pcpadd":"12301 Grapefield Rd","pcpcity":"Bastian                       ","pcpstate":"VA","pcpzip":243144547,"pcpcounty":"","pcpid":"P0132552","pcpname":"BLUEFIELD CLINIC COMPANY LLC","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":"","add2":"                                                            ","add3":"","madd1":"585 BRUSHFORK ROAD                                          ","madd2":"                                                            ","madd3":"","mcity":"FALLS MILLS                   ","mstate":"VA","mzip":"24613-9506","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["O35.8XX0","Z34.03","Z3A.29","O42.913","Z3A.31","O21.2","R11.2","M54.5","Z3A.30","Z3A.33","Z3A.35","Z3A.36","O26.893","R10.2","R10.9","N89.8","Z3A.37","O66.5","Z3A.38","Z37.0","O70.0","Z34.00","P59.9","Z00.111","L81.9","P28.89","R50.9","Z32.01","Z32.00","Z79.899","B34.9","R11.10","R52","Z88.6","Z88.8","M79.10","N13.30","Z33.1","O26.899","O99.613","K80.00","Z3A.28","O23.03","B96.20","M32.9","F41.9","O99.89","R10.30","Z34.92","K80.20","R10.13","O26.613","K82.A1","R10.11","O23.43","N13.6","O99.343","R68.89","N39.0","Z3A.24","O09.33","O99.619","K80.10","Z3A.00","K81.0","K81.9","O26.619","O21.8","Z48.815","O09.93","O36.63X0","Z34.83","R87.610","O47.03","R10.84","O32.1XX0","O60.03","Z3A.32","O36.8990","O36.8130","N76.0","M79.661","O36.5930","O34.33","O62.9","M79.7","Z90.49","Z91.013","Z91.018","O47.1","O26.03","O36.5130","O70.1","O69.81X0","K59.00","Z00.129","N92.1","Z39.2","Z30.09","B37.3","N92.0","N85.2","N94.9","R19.7","K91.5","R10.32","N97.9","Z01.818","Z20.828","N80.3","N73.6","N81.2","R59.1","R59.9","E28.2","N83.202","O03.9","N83.201","O26.891","N93.9","K52.9","R10.31","E86.0","N94.6","Z32.02"],"date":["2019-03-19","2019-04-02","2020-02-15","2019-02-13","2019-02-19","2020-02-10","2021-08-13","2020-10-26","2019-02-15","2019-03-05","2019-03-19","2019-03-28","2019-04-01","2020-12-04","2021-06-23","2021-07-13","2020-03-29","2019-04-07","2020-04-06","2020-04-06","2019-04-07","2019-04-07","2020-04-24","2020-04-24","2019-04-15","2019-04-16","2019-04-16","2019-09-10","2021-08-13","2019-09-10","2020-01-03","2020-01-03","2020-01-03","2020-03-29","2020-03-29","2020-01-03","2020-02-12","2020-02-10","2020-02-10","2020-02-11","2020-02-13","2020-02-13","2020-02-17","2020-02-10","2020-02-10","2020-02-11","2020-02-12","2020-02-10","2020-02-10","2020-02-15","2020-02-11","2020-02-15","2020-02-13","2020-07-22","2020-02-11","2020-02-11","2020-02-11","2020-02-11","2021-06-09","2020-02-12","2020-02-17","2020-02-12","2020-02-12","2020-02-12","2020-02-13","2020-02-13","2020-02-13","2020-02-14","2020-02-14","2020-04-06","2020-03-16","2020-02-17","2020-02-17","2020-03-27","2021-03-30","2020-02-25","2020-03-28","2020-03-08","2020-03-28","2020-03-27","2020-10-06","2020-03-11","2020-04-06","2020-03-29","2020-03-29","2020-04-06","2020-10-26","2020-03-29","2020-03-29","2020-04-03","2020-04-03","2020-04-06","2020-04-06","2020-04-06","2020-04-24","2020-04-24","2021-07-13","2020-05-18","2021-06-15","2020-05-18","2021-07-13","2021-07-13","2021-03-30","2021-06-23","2020-10-01","2020-12-04","2020-11-10","2020-12-01","2020-12-01","2021-03-30","2020-12-04","2020-12-04","2021-02-20","2021-02-20","2021-06-15","2021-06-09","2021-06-09","2021-07-13","2021-06-09","2021-06-09","2021-06-23","2021-06-23","2021-06-23","2021-08-10","2021-08-13"],"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":[["","50111033402","METRONIDAZOL","500MG","14","Select","Select",""],["","49884046565","CHOLESTYRAM","4GM","50","Select","Select",""],["","00555901658","SPRINTEC","28 DAY","28","Select","Select",""],["","00548570100","MEDROXYPR","150MG\/ML","1","Select","Select",""],["","00406012401","HYDROCO\/APAP","7.5-325","30","Select","Select",""],["","00093005805","TRAMADOL","50MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","500MG","28","Select","Select",""],["","57237007810","ONDANSETRON","8MG ODT","30","Select","Select",""],["","68382004101","PROMETHAZINE","25MG","30","Select","Select",""],["","65162047810","NITROFURANTN","100MG","14","Select","Select",""],["","16714036304","TRI-LINYAH","","28","Select","Select",""],["","55111014512","FLUCONAZOLE","150MG","2","Select","Select",""],["","00904505860","BISCOLAX","10MG","4","Select","Select",""],["","63044015001","PRENATAL","LOW IRON","30","Select","Select",""],["","00054001925","PREDNISONE","50MG","5","Select","Select",""],["","00904673060","ACETAMIN","500MG","30","Select","Select",""],["","50111033402","METRONIDAZOL ","TAB 500MG","14","Select","Select",""],["","49884046565","CHOLESTYRAM ","POW 4GM","50","Select","Select",""],["","00555901658","SPRINTEC ","TAB 28 DAY","28","Select","Select",""],["","00548570100","MEDROXYPR ","INJ 150MG\/ML","1","Select","Select",""],["","00406012401","HYDROCO\/APAP ","TAB 7.5-325","30","Select","Select",""],["","00093005805","TRAMADOL ","TAB 50MG","30","Select","Select",""],["","68180012202","CEPHALEXIN ","CAP 500MG","28","Select","Select",""],["","57237007810","ONDANSETRON ","TAB 8MG ODT","30","Select","Select",""],["","68382004101","PROMETHAZINE ","TAB 25MG","30","Select","Select",""],["","65162047810","NITROFURANTN ","CAP 100MG","14","Select","Select",""],["","16714036304","TRI-LINYAH ","TAB ","28","Select","Select",""],["","55111014512","FLUCONAZOLE ","TAB 150MG","2","Select","Select",""],["","00904505860","BISCOLAX ","SUP 10MG","4","Select","Select",""],["","63044015001","PRENATAL ","TAB LOW IRON","30","Select","Select",""],["","00054001925","PREDNISONE ","TAB 50MG","5","Select","Select",""],["","00904673060","ACETAMIN ","TAB 500MG","30","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","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["No","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":""}]}]}