{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CAROL   S DELOACH","gend":1,"add":"22311 MATTAPONI TRL","city":"MILFORD","state":"VA","zip":"22514-9998","dob":"1956-05-12","age":"","mstatus":"","insh":"900036551*01","cliId":"","pno":"804\/366-5638","cno":"804\/633-7454","email":"","ename":"","eno":"","pphy":"HUOT, RACHEL MD","ppno":"804\/632-1030","pcpadd":"102 W BROADDUS AVE SUITE 200","pcpcity":"BOWLING GREEN","pcpstate":"VA","pcpzip":22427,"pcpcounty":"","pcpid":"","pcpname":"CENTRAL VIRGINIA HEALTH SERVICES INC","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/632-1033","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M47.816","M47.817","M35.00","S62.002S","M15.9","M79.18","L30.9","F31.81","G93.40","Z68.38","R26.2","R29.6","R53.1","R41.82","I10.","Z86.59","E78.5","M54.2","S09.90XA","M47.812","M48.02","Z12.11","R32.","R15.9","N39.46","J01.80","Z78.9","J30.89","M32.9","G40.409","I25.9","M70.61","M48.061","R26.89","K08.89","K21.9","I25.10","I25.2","G62.9","Z86.73","Z79.899","M48.062","M54.16","Z13.29","Z13.21","J01.00","F39.","B00.1","K13.0","G93.41","E16.2","I95.9","E72.20","F31.9","G90.09","M06.9","M62.81","F41.9","G40.89","K58.1","F33.9","M19.90","E22.2","F05.","I65.21","T42.6X5A","G50.0","Z20.822","G40.909","K05.10","I63.50","R51.9","R10.30","G60.9","Z01.419","G89.29","M25.552","R53.83","M19.072","M19.071","M17.0","K59.09","D64.9","Z98.1","I73.9","M51.16","Z23.","R56.9","E87.1","E66.9","Z68.34","E78.00","Z79.82","Z47.89","L71.9","R68.84","K11.20","R68.0","I67.89","I51.7","M54.9","M25.562","S30.1XXA","S80.02XA","S80.01XA","S40.022A","S40.021A","Z87.11","R82.5","R19.7","M25.561","R51.","J18.9","R05.","H40.9","M54.5","R20.2","R42.","S16.1XXA","M41.9","R65.10","Z03.89","W19.XXXA","K63.89","E78.2","R13.10","G54.2","F07.81","M25.571","K05.219","I34.0","I35.8","I51.89","R27.9","Z76.89","M17.12","M47.12","J69.0","F31.30","M50.022","E03.9","Z91.81","Z88.1","M54.12","I65.23","W08.XXXA","W18.30XA","R40.2142","R40.2252","R40.2362","M47.9","M48.00","M54.6","Z01.812","Z98.890","F31.89","F33.1","R41.89","F43.21","F41.1","R47.81","Z68.36","F32.9","G50.8","E87.0","M15.0","Z12.31","Z78.0","E55.9","R76.0","W28.XXXA","R52.","R09.02","M79.673","M25.551","M48.07","R40.4","R40.2421","R40.20","E72.4","Z68.31","R29.818","G54.1","Z04.3","W22.8XXA","Y92.89","Y93.89","Z87.891","X50.1XXA","Z92.29","Z11.59","W18.09XA","Y92.009","S09.93XA","S80.11XA","S80.12XA","R10.32","W01.0XXA","R07.9","M50.00","E66.01","F31.70","M16.0","M79.671","G60.3","M25.461"],"date":["2020-10-14","2020-02-19","2020-05-04","2020-01-31","2020-05-26","2020-01-31","2020-09-03","2021-07-28","2021-07-10","2020-07-09","2020-07-06","2020-10-28","2020-07-29","2021-07-20","2021-12-02","2020-06-18","2021-12-02","2021-07-26","2020-09-26","2020-07-18","2020-09-26","2021-05-23","2020-09-18","2020-09-18","2020-09-18","2020-09-21","2020-09-21","2020-09-21","2021-07-28","2020-11-25","2020-10-28","2020-10-28","2020-12-01","2020-10-28","2020-10-11","2021-11-19","2021-11-19","2021-07-26","2021-07-28","2021-11-19","2021-11-19","2021-07-06","2020-10-21","2021-02-05","2021-02-05","2021-05-07","2021-11-09","2021-05-25","2021-05-25","2021-07-10","2021-07-08","2021-07-08","2021-07-30","2021-07-20","2021-07-08","2021-11-19","2021-07-02","2021-07-20","2021-07-01","2021-07-08","2021-07-08","2021-07-01","2021-07-09","2021-07-09","2021-07-09","2021-07-09","2021-07-09","2021-07-09","2021-07-09","2021-07-09","2021-07-09","2021-07-26","2021-07-26","2021-08-18","2021-09-28","2020-09-03","2020-09-03","2020-07-07","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2021-12-02","2020-10-20","2020-11-25","2020-11-25","2020-10-20","2021-07-10","2021-07-25","2020-10-20","2020-10-20","2020-10-20","2021-11-19","2020-11-25","2020-11-25","2021-07-08","2021-07-08","2021-07-08","2021-07-12","2021-07-26","2021-07-26","2021-12-09","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-11-19","2021-07-26","2020-04-07","2020-05-11","2020-07-18","2020-07-11","2020-06-19","2020-07-21","2021-01-13","2020-07-21","2020-09-26","2021-01-13","2021-01-13","2021-06-25","2021-07-09","2021-07-30","2020-06-19","2020-07-20","2020-07-13","2020-07-18","2020-07-18","2020-07-18","2021-05-07","2021-06-19","2021-06-19","2021-06-19","2021-07-27","2021-06-30","2021-12-09","2020-06-14","2020-06-14","2020-06-14","2020-06-14","2020-06-14","2020-10-14","2020-06-14","2020-06-14","2021-07-12","2020-07-06","2020-09-26","2020-07-09","2020-07-09","2020-07-09","2020-07-11","2020-07-11","2021-01-13","2021-07-01","2020-10-14","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-07-07","2021-07-09","2021-07-12","2021-07-25","2021-08-27","2021-07-28","2021-07-28","2021-12-08","2020-03-02","2020-05-04","2020-05-04","2020-06-03","2020-07-06","2020-07-06","2020-07-18","2020-07-18","2020-08-21","2021-06-17","2021-06-17","2021-06-17","2021-06-18","2021-06-18","2021-07-09","2020-06-17","2020-07-06","2020-09-26","2020-07-09","2020-07-09","2020-09-02","2020-09-26","2020-10-02","2020-10-16","2021-01-13","2021-01-13","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2021-07-26","2020-06-12","2020-06-17","2020-07-09","2020-07-09","2020-07-18","2020-07-18","2021-10-14","2021-11-19"],"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":[]}]},{"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":[["","65862076990","FENOFIBRATE                                                           ","145MG","90","Select","Select",""],["","00093100301","BUSPIRONE HCL                                                         ","15MG","-120","Select","Select",""],["","16729021716","SERTRALINE HYDROCHLORIDE                                              ","100MG","45","Select","Select",""],["","65862059505","DIVALPROEX SODIUM ER                                                  ","500MG ER","120","Select","Select",""],["","00093762698","PREGABALIN                                                            ","150MG","270","Select","Select",""],["","00527169505","BUTALBITAL\/ACETAMINOPHEN\/CAFFEINE                                     ","","30","Select","Select",""],["","00378395105","ATORVASTATIN CALCIUM                                                  ","20MG","30","Select","Select",""],["","13668044201","CELECOXIB                                                             ","200MG","90","Select","Select",""],["","64380080807","IBUPROFEN                                                             ","600MG","24","Select","Select",""],["","70710123001","AMITRIPTYLINE HYDROCHLORIDE                                           ","150MG","30","Select","Select",""],["","69238111801","BUSPIRONE HYDROCHLORIDE                                               ","15MG","120","Select","Select",""],["","65862014405","CARVEDILOL                                                            ","12.5MG","360","Select","Select",""],["","00713063737","METRONIDAZOLE                                                         ","0.75%","-135","Select","Select",""],["","00054327099","FLUTICASONE PROPIONATE                                                ","50MCG","-48","Select","Select",""],["","68180051703","LISINOPRIL                                                            ","40MG","90","Select","Select",""],["","00591079501","DICYCLOMINE HYDROCHLORIDE                                             ","20MG","20","Select","Select",""],["","00527131301","PILOCARPINE HYDROCHLORIDE                                             ","5MG","360","Select","Select",""],["","00406055201","OXYCODONE HYDROCHLORIDE                                               ","5MG","10","Select","Select",""],["","65162062711","TRAMADOL HCL                                                          ","50MG","30","Select","Select",""],["","00363876020","SENNA-S                                                               ","8.6-50MG","60","Select","Select",""],["","00363091106","                                                                      ","","60","Select","Select",""],["","69367022001","SODIUM CHLORIDE                                                       ","1GM","60","Select","Select",""],["","31722072690","MONTELUKAST SODIUM                                                    ","10MG","-30","Select","Select",""],["","23155013525","DOXYCYCLINE MONOHYDRATE                                               ","100MG","14","Select","Select",""],["","57237004101","PENICILLIN V POTASSIUM                                                ","500MG","30","Select","Select",""],["","57237002801","AMOXICILLIN                                                           ","500MG","20","Select","Select",""],["","00054429931","FUROSEMIDE                                                            ","40MG","-90","Select","Select",""],["","10135012310","ACETAMINOPHEN                                                         ","325MG","112","Select","Select",""],["","42858010201","OXYCODONE\/ACETAMINOPHEN                                               ","5-325MG","30","Select","Select",""],["","00406012305","HYDROCODONE\/ACETAMINOPHEN                                             ","5-325MG","9","Select","Select",""],["","63739043210","SENNOSIDES\/DOCUSATE SODIUM                                            ","8.6-50MG","90","Select","Select",""],["","00378668999","PANTOPRAZOLE SODIUM                                                   ","40MG","90","Select","Select",""],["","45802086803","POLYETHYLENE GLYCOL 3350                                              ","3350 NF","510","Select","Select",""],["","45802057178","FEXOFENADINE HYDROCHLORIDE                                            ","180MG","90","Select","Select",""],["","51672128902","NYSTATIN                                                              ","100000","30","Select","Select",""],["","00832712415","DIVALPROEX SODIUM DR                                                  ","500MG DR","-60","Select","Select",""],["","65862044990","VALACYCLOVIR HCL                                                      ","1GM","4","Select","Select",""],["","00131247735","VIMPAT                                                                ","50MG","-30","Select","Select",""],["","50383079516","LACTULOSE                                                             ","10GM\/15","1419","Select","Select",""],["","00005197102","PREVNAR 13                                                            ","","0","Select","Select",""],["","58160082311","SHINGRIX                                                              ","50\/0.5ML","1","Select","Select",""],["","00781707787","METRONIDAZOLE VAGINAL                                                 ","0.75%VAG","70","Select","Select",""],["","65162083366","DICLOFENAC SODIUM                                                     ","1%","-200","Select","Select",""],["","49281012165","FLUZONE HIGH-DOSE PF 2021-2022                                        ","2021-22","1","Select","Select",""],["","43598081115","CETIRIZINE HYDROCHLORIDE                                              ","10MG","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}