{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA   M MILES","gend":1,"add":"715 TRENTS MILL ROAD","city":"CUMBERLAND","state":"VA","zip":"23040-9998","dob":"1962-12-21","age":"","mstatus":"","insh":"20032081*01","cliId":"","pno":"804\/492-5806","cno":"","email":"","ename":"","eno":"","pphy":"CAMPANELLI, DAVID MD","ppno":"434\/581-3271","pcpadd":"25892 N JAMES MADISON HWY","pcpcity":"NEW CANTON","pcpstate":"VA","pcpzip":23123,"pcpcounty":"","pcpid":"","pcpname":"CENTRAL VIRGINIA HEALTH SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/581-1105","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D22.5","D18.01","D22.71","D22.72","Z85.820","Z86.006","Z12.83","D22.39","L90.5","G47.33","M25.531","R20.2","S92.403A","S92.919A","N17.9","E11.9","Z85.831","I89.0","I10.","D64.9","R60.9","NO DATA","Z79.899","M79.672","W19.XXXA","E11.3519","H92.12","H66.92","E66.01","R06.00","D53.9","D63.1","Z68.41","D48.9","H69.82","H61.23","D22.62","U07.1","B34.9","G56.01","L57.8","C44.612","L82.1","M54.5","M54.2","G89.29","S63.501A","M18.11","C49.9","C43.71","D22.61","M47.816","N18.3","R94.6","H61.21","S81.811A","M79.675","Z11.59","J20.9","J45.909","E11.3593","H43.11","Z96.22","R20.0","V58.89","L82.0","L81.4","D23.72","N18.30","L03.116","Z71.89","Z71.3","Z23.","E11.3393","H35.372","G56.11","E11.42","Z08.","S69.91XA","M79.676","Z98.890","L08.9","E11.69","L03.90","R07.9","Z79.4","Z45.2","R78.81","B95.61","R11.2","K21.9","N18.9","J45.21","E11.40","D03.9","T81.30XA","L02.416","L03.031","E79.0","J31.0","T48.5X1A","E11.22","I12.9","E11.51","M51.36","T82.898A","S80.211A","S50.311A","Z86.008","D23.5","A41.01","N18.2","J45.901","R00.0","R00.2","R04.0","T14.8XXA","B35.3","R19.7","R65.10","J45.20","C43.9","R79.89","E87.5","H40.053","H35.62","R50.9","R53.81","A41.9","C41.9","E11.3413","H04.123","L03.032","L98.9","T14.90XD","Z48.02","E11.3599","I73.9","E11.59","T88.7XXA","I87.2","Z91.89","B99.9","M25.551","S71.101A","D03.59","L91.8","D23.71","L98.5","R60.0","T82.598A","M62.81","D03.71","E78.5","R09.02","E11.649","E11.65","E11.319","H10.13","I78.1","L03.115","M62.830","M54.16","M54.31","M79.604","M25.561","D22.9","C44.91","N39.0","R39.9","J30.9","E11.3513","D23.9","D23.39","R06.02","R05.9","J06.9","J45.50","Z20.822","H26.9","H25.813","H25.012","H04.129","T23.221A","Z12.31","Z80.8","T23.021A","J10.1","R09.89","J02.9","R68.89","J02.0","H25.812"],"date":["2022-09-02","2022-06-01","2022-06-22","2022-06-01","2022-10-07","2021-12-17","2022-06-01","2021-04-28","2022-09-02","2022-09-14","2021-04-19","2021-04-19","2021-01-07","2020-12-17","2020-12-02","2021-03-19","2022-10-07","2020-12-02","2022-11-10","2021-11-15","2021-03-19","2022-11-10","2021-03-19","2020-12-02","2020-11-30","2022-08-11","2022-06-22","2021-05-17","2021-10-14","2021-11-15","2022-02-18","2022-11-10","2021-10-14","2022-09-02","2022-06-22","2021-04-19","2022-09-02","2021-01-29","2021-01-19","2022-01-28","2022-09-02","2021-12-17","2021-12-17","2021-09-23","2020-01-21","2021-11-05","2020-05-28","2020-05-28","2022-11-10","2021-09-17","2021-09-17","2022-01-28","2020-09-29","2020-08-19","2021-12-17","2020-09-29","2021-01-07","2021-01-16","2021-01-16","2022-11-25","2021-12-09","2022-08-11","2022-06-22","2021-04-19","2020-07-17","2021-04-28","2021-04-28","2021-04-28","2021-07-08","2020-01-22","2020-01-22","2020-01-22","2021-06-01","2021-05-17","2022-08-11","2021-06-07","2021-06-07","2020-05-14","2020-06-19","2020-12-17","2021-04-19","2019-07-31","2019-08-07","2019-08-02","2019-08-01","2019-08-07","2019-09-02","2019-09-01","2019-09-01","2019-08-05","2019-08-05","2019-09-01","2019-08-03","2019-08-20","2019-11-05","2019-11-05","2019-05-02","2019-06-10","2019-09-23","2019-05-15","2019-05-15","2022-06-06","2022-06-06","2019-09-01","2019-09-01","2019-08-31","2019-08-20","2019-08-20","2019-08-23","2019-08-23","2019-08-30","2019-08-30","2022-06-06","2022-06-06","2019-11-06","2019-03-16","2019-10-18","2019-06-10","2019-07-24","2019-07-22","2019-08-06","2019-10-31","2019-09-23","2019-09-23","2022-08-11","2019-12-17","2019-11-13","2019-07-27","2019-08-02","2019-08-02","2019-09-17","2019-09-17","2019-09-28","2019-09-30","2019-10-31","2019-10-31","2019-04-16","2019-05-24","2019-05-24","2019-08-03","2019-05-24","2019-07-30","2019-10-18","2019-10-18","2019-10-25","2019-03-20","2019-03-20","2019-03-20","2019-03-20","2019-07-25","2019-08-31","2019-01-11","2019-02-23","2019-07-25","2019-07-25","2019-07-25","2019-07-25","2019-07-25","2022-08-11","2019-10-12","2022-03-07","2022-10-03","2022-10-03","2022-10-03","2022-02-10","2022-08-04","2022-06-22","2022-03-02","2022-06-18","2022-06-18","2022-08-11","2022-08-11","2022-06-01","2022-06-01","2022-06-06","2022-11-25","2022-06-06","2022-06-06","2022-06-06","2022-11-10","2022-10-17","2022-04-14","2022-04-14","2022-10-07","2022-09-02","2022-09-02","2022-11-10","2022-11-19","2022-11-19","2022-11-19","2022-11-19","2022-11-19","2022-10-31"],"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":[["","43547038450","GABAPENTIN","CAP 300MG","270","Select","Select",""],["","00002850101","HUMULIN","INJ U-500","20","Select","Select",""],["","76204020025","ALBUTEROL","NEB 0.00083","300","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA BL","150","Select","Select",""],["","00173072020","FLOVENT","AER 220MCG","12","Select","Select",""],["","","ASPIRIN","CHW 81MG","","Select","Select",""],["","00172409680","BACLOFEN","TAB 10MG","45","Select","Select",""],["","00093220305","METOCLOPRAM","TAB 10MG","84","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","86227065055","INSULIN","MIS 0.5\/31G","100","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","00378363705","CETIRIZINE","TAB 10MG","31","Select","Select",""],["","60258015001","SF","CRE 0.011","51","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","","METANX","CAP ","","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","60","Select","Select",""],["","00378018105","ALLOPURINOL","TAB 300MG","30","Select","Select",""],["","","OFLOXACIN","DRO 0.3% OP","","Select","Select",""],["","","FEROSUL","TAB 325MG","","Select","Select",""],["","59746017509","PREDNISONE","TAB 20MG","24","Select","Select",""],["","","ATORVASTATIN","TAB 20MG","","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","30","Select","Select",""],["","00093206406","CILOSTAZOL","TAB 100MG","60","Select","Select",""],["","","CLONIDINE","TAB 0.1MG","","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00713068231","GENTAMICIN","OIN 0.001","30","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","10","Select","Select",""],["","55111072510","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","16729041501","DOXAZOSIN","TAB 8MG","60","Select","Select",""],["","10370083111","DILTIAZEM","CAP 240MG ER","30","Select","Select",""],["","00054429731","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","47781049005","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","51672208002","TERBINAFINE","CRE 0.01","30","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","3","Select","Select",""],["","51991091390","FOLTANX","CAP ","30","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","Select","Select",""],["","71849010090","METHYLFOL\/ME","CAP CBL\/P5P","30","Select","Select",""],["","31722063031","OSELTAMIVIR","CAP 30MG","10","Select","Select",""],["","45802005505","TRIAMCINOLON","OIN 0.001","80","Select","Select",""],["","60758011910","PREDNISOLONE","SUS 1% OP","10","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20","Select","Select",""],["","63824000832","MUCINEX","TAB 600MG ER","14","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","64980030550","DENTA","CRE PLUS","51","Select","Select",""],["","49281063515","FLUZONE","INJ 2021-22","0","Select","Select",""],["","","NITROFURANTN","CAP 100MG","","Select","Select",""],["","","FREESTYLE    KIT SENSOR","KIT SENSOR","","Select","Select",""],["","","APAP\/CODEINE","TAB 300-30MG","","Select","Select",""],["","61314064511","NEO\/POLY\/HC","SUS 1% OTIC","10","Select","Select",""],["","","FREESTYLE    MIS READER","MIS READER","","Select","Select",""],["","","THERA-M","TAB ","","Select","Select",""],["","","DOXYCYC","TAB 100MG","","Select","Select",""],["","65702043810","ACCU-CHEK","TES AVIVA PL","150","Select","Select",""],["","00904571135","NASAL","SPR 0.0005","15","Select","Select",""],["","61314022505","TIMOLOL","SOL 0.5% OP","5","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","8000","Select","Select",""],["","53746027205","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","76478000205","BETIMOL","SOL 0.005","5","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","65162074510","PROMETHAZINE","TAB 12.5MG","60","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}