{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BRANDY   M JUSTUS","gend":1,"add":"607 LINDEN PL","city":"SOUTH BOSTON","state":"VA","zip":"24592-9998","dob":"1988-09-27","age":"","mstatus":"","insh":"20030452*01","cliId":"","pno":"434\/272-2330","cno":"434\/228-6766","email":"","ename":"","eno":"","pphy":"ROBERTS, MAURICE NP","ppno":"434\/835-4876","pcpadd":"3130 HALIFAX ROAD SUITE C","pcpcity":"SOUTH BOSTON","pcpstate":"VA","pcpzip":24592,"pcpcounty":"","pcpid":"","pcpname":"GODOCS SOUTH BOSTON LLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/835-4875","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F43.10","Z20.828","J01.90","J30.1","N89.8","R42.","L73.2","D17.23","A63.0","F60.9","F45.21","Z72.0","R06.00","G47.10","F17.290","Z23.","F32.9","F60.3","B00.9","G43.109","R20.0","Z51.81","F34.1","J20.9","B96.89","K04.7","L73.1","F33.1","B99.9","N76.0","R30.9","R09.81","R44.8","J34.2","J34.3","R09.82","Z88.0","B37.3","Z11.3","K11.21","D72.829","E61.1","G06.2","F41.8","J06.9","H69.81","J30.9","L02.92","R05.","J01.00","R39.9","T78.40XA","L02.211","R53.82","Z30.431","R30.0","S29.011A","N61.1","R10.2","E78.2","L03.313","B35.4","M79.604","Z30.430","Z01.812","Z32.02","M54.5","F17.210","K59.00","R10.9","R35.0","M62.830","M54.30","E78.00","Z79.899","Z88.1","Z88.2","Z88.8","Z30.012","R21.","Z30.09","M62.838","M54.41","M54.42","G56.03","M25.541","M25.531","M25.532","R60.9","R07.89","R00.0","N90.89","M62.831","K21.9","R07.9","E66.9","Z68.41","K76.0","M79.661","NO DATA","R06.09","B37.2","J01.40","E03.9","R73.01","L03.011","B37.0","Z01.419","R00.2","J39.9","E66.01","R07.2","Z68.36","R10.13","R19.4","R14.0","J34.89"],"date":["2022-11-09","2022-07-13","2021-09-23","2022-09-30","2021-12-09","2022-05-23","2020-09-08","2020-08-05","2020-09-08","2021-02-25","2022-06-24","2020-12-12","2022-05-09","2022-02-07","2022-02-07","2021-10-12","2020-01-15","2020-06-04","2020-01-18","2020-07-02","2020-07-02","2021-05-11","2021-09-20","2022-02-07","2020-03-24","2020-10-26","2021-12-02","2021-08-04","2020-03-31","2022-06-06","2020-08-04","2021-10-28","2021-10-28","2021-10-28","2021-10-28","2021-10-28","2021-10-28","2022-09-14","2022-05-26","2020-11-18","2021-06-29","2021-06-29","2021-08-30","2022-09-28","2021-12-20","2020-02-20","2020-04-09","2020-04-09","2021-05-04","2021-05-04","2021-09-01","2021-12-20","2020-06-08","2021-06-17","2020-10-08","2020-10-08","2019-02-21","2019-06-04","2019-08-13","2022-08-19","2019-06-24","2019-06-24","2022-10-13","2019-08-01","2019-08-01","2019-08-01","2019-09-10","2022-05-18","2019-09-10","2019-09-10","2022-09-14","2019-01-08","2019-01-08","2022-10-13","2019-01-08","2022-10-13","2019-01-08","2019-01-08","2019-04-13","2019-04-13","2019-07-18","2019-01-08","2022-10-13","2019-01-08","2019-08-20","2019-08-20","2019-08-20","2019-08-20","2019-08-17","2022-04-20","2022-04-20","2022-05-02","2022-10-13","2022-05-02","2022-03-15","2022-03-15","2022-03-15","2022-05-02","2022-10-13","2022-06-23","2022-05-18","2022-09-14","2022-05-23","2022-08-19","2022-08-19","2022-06-23","2022-09-30","2022-01-27","2022-04-18","2022-01-13","2022-10-13","2022-03-15","2022-10-13","2022-03-22","2022-03-22","2022-03-22","2022-08-09"],"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":[["","","ESCITALOPRAM","TAB 10MG","","Select","Select",""],["","68382050010","OMEPRAZOLE","CAP 40MG","90","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","","CYMBALTA"," CYMBALTA ","60","Select","Select",""],["","00254100752","ALBUTEROL","AER HFA","7","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","14","Select","Select",""],["","00054004641","IPRATROPIUM","SPR 0.0006","15","Select","Select",""],["","00093720198","PRAVASTATIN","TAB 20MG","30","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","28","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","5","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00536589671","NICOTINE","DIS 21MG\/24H","28","Select","Select",""],["","","AZITHROMYCIN"," AZITHROMYCIN ","6","Select","Select",""],["","","CEFUROXIME","TAB 250MG","","Select","Select",""],["","00472037945","CLOTRIM\/BETA","CRE DIPROP","45","Select","Select",""],["","66993066260","DULOXETINE","CAP 20MG","30","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","11917014671","OMEGA-3","CAP 1000MG","30","Select","Select",""],["","11877001140","BINAXNOW","KIT HOME TES","8","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","45802010901","TRIAMCINOLON","AER 55MCG\/AC","17","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","66689000816","NYSTATIN","SUS 100000","60","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","70377002711","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","68180046707","LOVASTATIN","TAB 10MG","30","Select","Select",""],["","68180059206","DESVENLAFAX","TAB 50MG ER","30","Select","Select",""],["","59779045806","CVS","TAB 10MG","30","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","59267100002","PFIZER","INJ COVID-19","0","Select","Select",""],["","13107008405","LORAZEPAM","TAB 1MG","14","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","20","Select","Select",""],["","11917018320","BUDESONIDE","SUS 32MCG","8","Select","Select",""],["","","VALACYCLOVIR","TAB 1GM","","Select","Select",""],["","","BROM\/PSE\/DM","SYP ","","Select","Select",""],["","51672130406","TERCONAZOLE","CRE 0.004","45","Select","Select",""],["","50428829925","FISH","CAP 1000MG","30","Select","Select",""],["","","EAR","DRO 0.065","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","IMIQUIMOD","CRE 0.05","","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","40","Select","Select",""],["","","MINOCYCLINE","CAP 100MG","","Select","Select",""],["","","FLUVOXAMINE","TAB 100MG","","Select","Select",""],["","","HIBICLENS","LIQ 0.04","","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":""}]}]}