{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ROSA   L ADAMS","gend":1,"add":"530 BRIDGESTONE DR LOT 8","city":"RAVEN","state":"VA","zip":"24639-9998","dob":"1955-07-26","age":"","mstatus":"","insh":"20062014*01","cliId":"","pno":"276\/345-4073","cno":"","email":"","ename":"","eno":"","pphy":"MCVEY, KENNETH A DO","ppno":"276\/964-6771","pcpadd":"1 CLINIC DRIVE CLAYPOOL HILL","pcpcity":"RICHLANDS","pcpstate":"VA","pcpzip":24641,"pcpcounty":"","pcpid":"","pcpname":"CLINCH VALLEY PHYSICIANS ASSOCIATES LLC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/964-1314","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L02.414","J44.1","R07.9","I50.32","F17.210","J44.9","I50.9","G47.33","G47.11","L21.8","L53.8","L82.0","L57.0","R06.02","L85.3","D48.5","R39.81","N39.490","J96.01","K21.9","R06.00","R94.31","H16.223","H25.813","H53.10","Z91.19","Z99.81","NO DATA","Z79.51","Z79.899","A63.0","M79.661","M79.605","L82.1","L81.4","L08.9","R60.0","M79.662","Z72.0","J96.11","G47.10","Z99.89","N39.3","F32.9","L28.0","R07.89","I34.0","I51.7","R05.","F17.209","L02.512","Z01.411","Z12.4","Z12.31","Z13.820","R87.610","M85.80","D25.1","M76.61","M79.671","R53.1","Z74.01","R06.09","Z74.3","R06.83","H40.023","H25.13","F17.200","Z20.822","R10.31","R10.9","K80.20","K44.9","K76.0","K57.30","R59.0","J98.4","D73.89","Z86.79","R11.0","F41.8","Z83.3","E78.5","R73.03","I87.2","N36.42","R39.13","R39.12","R60.9","I73.9","R21.","Z87.891","R10.30","N90.89","Z11.52"],"date":["2021-07-28","2022-04-05","2022-07-10","2020-02-24","2022-04-05","2022-07-10","2022-07-10","2021-12-11","2021-05-24","2021-11-24","2022-09-08","2022-09-08","2021-10-18","2022-04-05","2021-11-24","2021-11-24","2022-08-23","2022-08-23","2020-02-20","2022-07-10","2020-02-25","2020-02-24","2021-02-23","2021-02-23","2021-02-23","2021-11-15","2022-03-09","2022-07-10","2022-03-09","2022-07-10","2020-09-22","2021-03-19","2021-03-19","2021-07-19","2022-09-08","2021-05-25","2022-07-10","2021-03-19","2021-03-19","2021-11-11","2021-12-11","2021-11-11","2022-03-08","2021-11-11","2021-12-17","2022-03-09","2020-02-25","2020-02-25","2020-03-24","2020-03-24","2020-11-01","2021-05-13","2021-05-13","2022-09-06","2021-05-13","2021-06-03","2021-06-03","2021-06-03","2020-03-05","2020-03-05","2022-03-10","2021-11-15","2022-03-09","2021-11-15","2021-05-24","2019-12-11","2019-12-11","2019-12-11","2022-04-05","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-09","2022-03-04","2022-03-04","2022-03-04","2022-03-04","2022-07-10","2022-03-08","2022-03-08","2022-03-08","2022-07-10","2022-07-10","2022-07-10","2022-07-10","2022-03-09","2022-09-06","2022-03-11"],"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":[["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","16714089802","LORATADINE","TAB 10MG","30","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","00487950160","ALBUTEROL","NEB 0.00083","360","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","00832532211","POT  CHLORIDE","TAB 8MEQ ER","30","Select","Select",""],["","62135098505","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","65862019499","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","33342032954","TRIAMCINOLON","CRE 0.001","454","Select","Select",""],["","00054982831","PREDNISONE","TAB 5MG","10","Select","Select",""],["","45802000403","HYDROCORT","CRE 0.025","28","Select","Select",""],["","","IMIQUIMOD","CRE 0.05","","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","51672131201","MUPIROCIN","OIN 0.02","15","Select","Select",""],["","21922002507","KETOCONAZOLE","CRE 0.02","60","Select","Select",""],["","00904598463","AMMONIUM","LOT 0.12","396","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","57237023305","SMZ-TMP","TAB 800-160","20","Select","Select",""],["","","BUDES\/FORMOT","AER 160-4.5","","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","LEVOFLOXACIN","TAB 500MG","","Select","Select",""],["","","NICOTINE","DIS 21MG\/24H","","Select","Select",""],["","","CLINDAMYCIN","CAP 300MG","","Select","Select",""],["","","IBUPROFEN","TAB 800MG","","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":""}]}]}