{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AUGUSTUS   L JARMANS","gend":0,"add":"403 N COALTER ST RITENOUR HOUSE","city":"STAUNTON","state":"VA","zip":"24401-9998","dob":"1976-03-18","age":"","mstatus":"","insh":"20049087*01","cliId":"","pno":"304\/240-0003","cno":"","email":"","ename":"","eno":"","pphy":"AGYEIWAAH, MAVIS A MD","ppno":"540\/536-5400","pcpadd":"1440 AMHERST ST","pcpcity":"WINCHESTER","pcpstate":"VA","pcpzip":22601,"pcpcounty":"","pcpid":"","pcpname":"VALLEY PHYSICIAN ENTERPRISE INC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/536-5490","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R79.1","F33.2","R06.02","R91.8","R09.02","D68.51","R10.84","Z71.3","Z68.36","R10.12","Z20.822","G62.9","R26.81","J44.1","S22.31XA","D68.59","R07.9","J18.9","K56.7","J44.0","K92.0","F60.3","Z20.828","F41.9","K59.09","F32.9","K21.9","F41.0","F43.10","F17.210","K22.719","E86.0","R11.2","K59.00","R10.13","R11.15","K42.9","F12.10","Z79.01","J44.9","J96.01","R10.9","R10.10","R00.1","R68.83","F19.10","Z91.89","M54.5","Z86.010","K22.70","K22.4","R10.32","Z12.11","K44.9","K63.5","K31.89","K64.8","R63.4","R93.3","R10.0","R53.1","R10.11","J16.8","F12.90","Z72.0","Z87.19","Z87.09","K58.9","M79.662","J20.9","J45.901","D68.2","R09.81","R05.","Z86.711","E53.8","R10.33","F33.1","E66.01","Z13.220","Z13.1","R55.","M79.605","K52.9","F10.10","R56.9","F10.231","F10.232","F10.20","V62.84","F31.62","Z11.1","R06.00","Z86.718","M79.89","D68.9","E87.6","F10.220","F43.20","H54.61","G89.29","K29.20","F10.239","R51.","Z74.3","R11.14","K22.8","R19.7","R11.10","M79.604","F10.230","H53.8","R42.","M27.3","K08.89","Z68.34","R11.0","R25.1","S00.83XA","S40.021A","M54.9","M54.2","Z23.","W10.9XXA","E51.2","F10.26","V72.85","Z90.49","R53.83","Y90.5","I26.99","I82.409","R29.6","K29.00","S20.211A","W11.XXXA","B34.9","G63.","K04.7","R03.0","N28.89","J01.90","K02.9","R68.84"],"date":["2021-04-15","2022-10-04","2020-07-27","2020-07-07","2020-07-07","2022-09-15","2021-05-05","2020-07-27","2020-07-27","2022-03-03","2021-06-10","2021-12-06","2021-12-06","2020-11-17","2020-03-10","2020-07-04","2020-05-12","2020-07-06","2021-05-15","2020-07-04","2020-07-04","2021-08-19","2020-07-07","2020-07-04","2020-07-04","2020-07-04","2022-09-29","2020-07-04","2021-02-22","2020-07-04","2021-02-22","2022-07-17","2022-09-29","2021-06-14","2022-09-29","2021-03-10","2021-03-10","2021-03-23","2022-09-29","2021-08-19","2020-07-07","2021-10-29","2020-08-26","2020-08-26","2020-08-26","2021-03-25","2021-03-25","2021-03-25","2021-06-14","2021-06-14","2021-05-05","2022-07-18","2021-06-14","2021-06-14","2021-06-14","2021-06-14","2021-06-14","2021-01-05","2020-07-05","2022-03-03","2020-07-18","2020-07-18","2020-07-18","2020-07-18","2021-02-22","2020-07-18","2020-07-18","2021-04-15","2021-07-23","2020-02-29","2020-02-29","2021-02-22","2020-03-08","2020-03-08","2020-03-08","2022-10-25","2021-02-22","2022-07-01","2021-02-22","2021-02-22","2021-02-22","2021-05-15","2021-07-23","2021-10-29","2019-02-09","2019-01-08","2019-07-28","2019-03-26","2019-02-12","2019-02-12","2019-07-02","2019-03-12","2019-03-30","2019-12-24","2019-03-30","2019-02-08","2019-02-10","2019-07-26","2019-02-08","2019-02-08","2019-02-08","2019-08-01","2019-08-01","2019-11-27","2022-03-03","2019-07-28","2019-08-01","2022-07-18","2022-07-17","2019-03-30","2019-01-05","2019-01-14","2019-01-14","2019-12-20","2022-07-01","2019-07-26","2019-01-20","2019-01-05","2019-01-20","2019-01-20","2019-01-20","2019-01-20","2019-01-20","2019-01-20","2019-01-05","2019-01-05","2019-01-05","2019-01-05","2019-01-20","2019-02-08","2019-03-26","2019-03-26","2019-07-02","2019-07-27","2019-08-21","2019-08-21","2022-07-17","2022-07-05","2022-08-30","2022-08-30","2022-09-29","2022-07-01","2022-07-01","2022-11-02"],"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":[["","43547040611","CLONAZEPAM","TAB 0.5MG","90","Select","Select",""],["","51645090501","VITAMIN","TAB 100MG","27","Select","Select",""],["","00597002402","COMBIVENT","AER 20-100","4","Select","Select",""],["","00093172001","WARFARIN","TAB 10MG","30","Select","Select",""],["","","FAMOTIDINE","TAB 40MG","","Select","Select",""],["","57237007810","ONDANSETRON","TAB 8MG ODT","30","Select","Select",""],["","00093227534","AMOX\/K","TAB 875-125","20","Select","Select",""],["","67877022405","GABAPENTIN","CAP 400MG","180","Select","Select",""],["","16729017201","AMITRIPTYLIN","TAB 25MG","28","Select","Select",""],["","00456120130","LINZESS","CAP 145MCG","30","Select","Select",""],["","43386031214","GAVILAX","POW ","510","Select","Select",""],["","00781223410","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","65162089703","ARIPIPRAZOLE","TAB 5MG","30","Select","Select",""],["","","DICYCLOMINE","CAP 10MG","","Select","Select",""],["","68180035302","SERTRALINE","TAB 100MG","60","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","15","Select","Select",""],["","00093005805","TRAMADOL","TAB 50MG","12","Select","Select",""],["","00955100410","ENOXAPARIN","INJ 40\/0.4ML","6","Select","Select",""],["","","HALOPERIDOL","TAB 2MG","","Select","Select",""],["","00093216568","NALOXONE","SPR ","2","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","","POLYETH","POW 3350 NF","","Select","Select",""],["","10310022240","ORAJEL","GEL 0.1","7","Select","Select",""],["","50486055032","ZILACTIN-B","GEL 0.1","7","Select","Select",""],["","00283087131","HURRICAINE","GEL 0.2","30","Select","Select",""],["","19515080852","FLULAVAL","INJ 2022-23","0","Select","Select",""],["","","SUCRALFATE","TAB 1GM","","Select","Select",""],["","","PEG3350","POW ","","Select","Select",""],["","","HYDROCO\/APAP","TAB 5-325MG","","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","30","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","50428166363","BISACODYL","TAB 5MG EC","4","Select","Select",""],["","69680011225","CYANOCOBALAM","INJ 1000MCG","4","Select","Select",""],["","70000041503","CLEARLAX","POW ","510","Select","Select",""],["","69315012710","FOLIC","TAB 1000MCG","27","Select","Select",""],["","70461042110","FLUCLVX","INJ 2021-22","0","Select","Select",""],["","00054001825","PREDNISONE","TAB 20MG","10","Select","Select",""],["","63304069201","CLINDAMYCIN","CAP 150MG","14","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","20","Select","Select",""],["","","CVS","POW ","","Select","Select",""],["","","MIRALAX","POW 3350 NF","","Select","Select",""],["","","DOCUSATE","CAP 100MG","","Select","Select",""],["","57664022388","OXYCODONE","TAB 5MG","20","Select","Select",""],["","42858010301","OXYCOD\/APAP","TAB 7.5-325","20","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00536344238","CEROVITE","TAB ADVANCED","30","Select","Select",""],["","50111043403","TRAZODONE","TAB 100MG","30","Select","Select",""],["","51224020630","NALTREXONE","TAB 50MG","30","Select","Select",""],["","40093010209","MAG","CAP 500MG","25","Select","Select",""],["","00173085910","BREO","INH 100-25","60","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","00904053980","THERA","TAB ","28","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","32","Select","Select",""],["","13107005999","APAP\/CODEINE","TAB 300-30MG","12","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","49348057236","SM","GUM 4MG","110","Select","Select",""],["","00536110788","NICOTINE","DIS 14MG\/24H","14","Select","Select",""],["","00904264113","CERTAVITE\/","TAB ANTIOXID","28","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","10135065201","B-12","TAB 1000MCG","27","Select","Select",""],["","00115169449","EPINEPHRINE","INJ 0.3MG","2","Select","Select",""],["","33332031901","AFLURIA","INJ 2019-20","0","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":""}]}]}