{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VANESSA   D RIVES","gend":1,"add":"401 ROBERTS AVE APT 709","city":"PETERSBURG","state":"VA","zip":"23805-9998","dob":"1961-09-04","age":"","mstatus":"","insh":"20034065*01","cliId":"","pno":"804\/968-9659","cno":"","email":"","ename":"","eno":"","pphy":"FLEENOR, ELLEN T MD","ppno":"804\/733-5591","pcpadd":"321 C POPLAR DRIVE","pcpcity":"PETERSBURG","pcpstate":"VA","pcpzip":23805,"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":"804\/733-3506","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M77.12","M43.16","M54.5","H90.0","H25.13","G47.33","J34.3","H69.83","H90.6","Z68.41","Z01.810","I49.3","I10.","K21.9","J45.909","NO DATA","F32.9","I49.9","Z68.38","E55.9","R11.2","R12.","Z87.11","M47.26","R00.1","E66.01","M54.16","Z98.1","F17.210","Z88.0","Z88.2","Z82.49","M54.10","R07.89","I47.1","R00.2","R10.13","Z79.899","K29.50","K25.9","K57.30","K64.8","H25.12","I44.1","I49.5","Z68.39","Z20.822","Z87.891","R07.9","I47.2","I25.10","M25.532","Z71.89","Z71.3","Z23.","R73.03","Z11.4","Z11.59","F17.200","Z12.31","M77.11","R94.39","V43.52XA","R10.30","M16.0","R20.0","H69.93","E78.5","G56.01","G56.02","R06.83","S93.402A","M76.822","H92.01","F33.8","I70.211","H25.11","Z71.9","M25.551","M25.552","J06.9","M54.17","M48.07","Z13.1","Z13.0","H61.23","H90.3","Z01.818","R00.0","R07.2","M54.41","R11.10","S73.191A","I48.91","I51.7","I50.30","I36.1","R42.","Z12.11","Z13.29","Z13.220","J40.","H65.23","J31.2","R59.0","J35.1","J32.9","E11.9","K29.00","R10.12","M25.561","M94.0","J31.0","Z12.39","R10.33","H92.03","R53.83","K57.92","R10.31","N82.4","K57.32","N82.3","Z90.49","Z98.890","N94.89","R10.2","R19.00","Z48.816","Z48.815","M70.62","M51.16","G89.29","K27.9","J42.","R20.2","Z09.","R11.0","G89.18","Z48.89","J01.80","J01.00","N83.9","E66.9","E78.00","K66.0","Z90.721","Z90.711","Z95.0","E78.2","T78.40XA","M79.604","R26.89","Z79.51","Z79.82","Z90.710","N83.8","D27.1","Z68.42"],"date":["2020-04-14","2022-07-12","2021-09-30","2022-11-16","2021-02-12","2022-10-12","2022-03-28","2022-11-16","2021-09-29","2022-08-25","2021-10-05","2021-10-05","2022-10-12","2022-06-13","2022-07-12","2022-07-12","2022-04-13","2022-07-12","2022-04-13","2022-08-25","2020-02-25","2020-01-28","2022-06-13","2020-02-24","2020-05-17","2022-06-13","2022-11-14","2022-06-13","2020-06-16","2020-06-16","2020-06-16","2020-06-16","2020-06-16","2022-08-17","2020-11-18","2022-08-18","2021-02-10","2022-02-21","2021-02-10","2021-02-10","2021-02-10","2021-02-10","2021-03-25","2022-01-25","2022-01-25","2021-09-27","2022-02-21","2022-06-13","2022-08-18","2022-08-18","2022-08-18","2020-01-29","2022-07-11","2022-07-11","2021-11-22","2022-08-25","2020-10-23","2020-10-23","2022-02-21","2021-05-06","2021-01-25","2021-01-29","2021-06-24","2021-08-05","2021-09-07","2021-08-05","2021-08-12","2022-06-13","2022-03-05","2022-03-05","2022-03-05","2021-09-21","2021-09-21","2021-01-20","2020-07-24","2020-10-21","2021-04-01","2022-01-03","2022-02-21","2021-09-07","2022-02-10","2020-06-16","2020-06-16","2022-08-25","2020-02-05","2021-01-20","2022-11-16","2021-03-17","2021-10-06","2020-05-17","2020-05-17","2020-05-17","2020-07-27","2020-07-13","2020-08-12","2020-08-12","2020-08-12","2020-11-18","2021-01-27","2021-05-06","2021-05-06","2022-08-25","2019-05-13","2019-08-23","2019-04-08","2019-04-08","2019-06-14","2019-06-14","2019-03-27","2019-03-27","2019-08-26","2019-01-02","2019-05-13","2019-12-19","2019-03-27","2019-08-05","2022-01-25","2022-03-03","2022-03-03","2022-07-18","2022-07-12","2022-07-12","2022-07-18","2022-07-18","2022-03-23","2022-03-23","2022-05-17","2022-07-12","2022-07-12","2022-07-12","2022-07-12","2022-07-12","2022-07-12","2022-07-12","2022-07-12","2022-08-25","2022-07-11","2022-07-11","2022-10-17","2022-01-13","2022-02-15","2022-06-13","2022-06-13","2022-06-13","2022-06-13","2022-06-13","2022-06-13","2022-06-13","2022-08-25","2022-05-09","2022-02-10","2022-07-15","2022-02-21","2022-02-21","2022-02-21","2022-04-13","2022-06-13","2022-11-16"],"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":[["","","IRBESARTAN"," IRBESARTAN ","30","Select","Select",""],["","","DULERA","AER 50-5MCG","","Select","Select",""],["","62559016701","OXYCODONE","CAP HCL 5MG","15","Select","Select",""],["","","PANTOPRAZOLE"," PANTOPRAZOLE ","30","Select","Select",""],["","","ATORVASTATIN"," ATORVASTATIN ","30","Select","Select",""],["","","FUROSEMIDE"," FUROSEMIDE ","30","Select","Select",""],["","57896022110","ACETAMIN","TAB 500MG","180","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","12","Select","Select",""],["","","ALBUTEROL"," ALBUTEROL ","300","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","18","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","20","Select","Select",""],["","00603158654","PROMETHAZINE","SYP DM","140","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","30","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","69315030615","NYSTATIN","POW 100000","15","Select","Select",""],["","42806071501","BENZONATATE","CAP 200MG","45","Select","Select",""],["","42806054701","VITAMIN","CAP 1.25MG","4","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","50228046501","NABUMETONE","TAB 500MG","60","Select","Select",""],["","","HYDRALAZINE"," HYDRALAZINE ","60","Select","Select",""],["","","AMLODIPINE"," AMLODIPINE ","30","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","30","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","68462010530","ONDANSETRON","TAB 4MG","15","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","14","Select","Select",""],["","69097067905","PREGABALIN","CAP 75MG","60","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","24979003903","METOPROL","TAB 100MG ER","30","Select","Select",""],["","61314063710","PREDNISOLONE","SUS 1% OP","10","Select","Select",""],["","00173069500","ADVAIR","AER 100\/50","60","Select","Select",""],["","64980051505","OFLOXACIN","DRO 0.3% OP","5","Select","Select",""],["","61314012605","KETOROLAC","SOL 0.005","5","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","10572010001","PEG-3350","SOL ELECTROL","4000","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","15","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","42","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","42799011101","ETODOLAC","TAB 400MG","60","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","58657050916","GUAIFENESIN","LIQ 100\/5ML","210","Select","Select",""],["","43598044556","NICOTINE","KIT TRANSDER","56","Select","Select",""],["","00574200815","NYSTOP","POW 100000","15","Select","Select",""],["","","LISINOPRIL","TAB 10MG","","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00378932032","WIXELA","AER 100\/50","60","Select","Select",""],["","","PROVENTIL","AER HFA","","Select","Select",""],["","","LANTUS","INJ 100\/ML","","Select","Select",""],["","","SIMVASTATIN","TAB 40MG","","Select","Select",""],["","","FLUTIC\/SALME","AER 100\/50","","Select","Select",""],["","","CLONAZEPAM","TAB 0.5MG","","Select","Select",""],["","","SERTRALINE","TAB 100MG","","Select","Select",""],["","","METOPROLOL","TAB 50MG ER","","Select","Select",""],["","","POT  CHLORIDE","TAB 10MEQ ER","","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":""}]}]}