{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LILLIAN SWEET","gend":1,"add":"5 RHODES CT","city":"LEXINGTON","state":"VA","zip":"24450-9998","dob":"2002-03-20","age":"","mstatus":"","insh":"8010404*01","cliId":"","pno":"540\/457-5008","cno":"","email":"","ename":"","eno":"","pphy":"BERRY, ELIZABETH NP","ppno":"540\/245-7870","pcpadd":"2570 STUARTS DRAFT HWY SUITE 101","pcpcity":"STUARTS DRAFT","pcpstate":"VA","pcpzip":24477,"pcpcounty":"","pcpid":"","pcpname":"AUGUSTA MEDICAL GROUP","plan":"OHP","program":"MEDICAID","lob":"M4","region":"ROANOKE ALLEGHANY","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/245-7871","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.10","R07.89","R42.","R06.02","E10.10","E87.1","N17.9","E87.2","E10.649","E87.6","E78.5","F32.9","Z79.4","Z91.19","Z91.14","Z91.11","Z88.1","Z82.49","Z03.818","R11.10","R06.82","K85.80","R00.0","K85.90","E10.65","A59.9","E88.81","E78.1","E83.39","N89.8","Z30.42","G93.41","E83.51","D72.829","K21.9","E10.43","K31.84","NO DATA","T68.XXXA","E86.0","Z86.16","M41.9","Z88.0","E55.9","Z83.3","V58.69","Z91.128","E83.31","R11.2","E10.42","F12.90","Z20.822","Z79.899","R82.90","N76.0","A59.00","A59.01","R07.9","R46.89","B37.3","U07.1","K52.9","L50.8","E83.42","R21.","R10.13","E87.5","D72.819","R41.82","E87.8","V62.84","F33.41","F41.8","N39.0","E13.10","R10.31","R68.0","M54.2","M54.6","M54.5","V89.2XXA","S16.1XXA","Z53.29","V48.6XXA","Y93.19","Z20.828","E10.9","Z30.9","E11.43","E13.11","R74.8","F39.","F43.25","R73.9","R40.4","Z11.59","F33.1","Z77.22","S19.9XXA","R11.0","R03.0","R35.0","R30.0","J06.9","N76.4","R80.9","Z63.79","E78.2","N94.6","F43.21","Z11.3","N92.1","Z30.013","F32.1","R41.840","G43.909","E78.00","I10.","F41.9","Z79.84","R30.9","R81.","E10.8","N92.6","Z86.39","F54.","R53.83","E08.10","M79.2","M41.84","F17.220","F17.200","F12.10","R10.0","K04.7","Z72.0","F17.210","M41.119","M41.80"],"date":["2021-07-10","2021-07-08","2021-07-08","2021-07-08","2022-02-21","2021-09-14","2022-02-21","2021-10-01","2021-09-12","2022-02-21","2022-02-20","2022-07-14","2022-02-20","2022-07-14","2021-10-01","2021-09-12","2021-09-12","2021-09-12","2021-09-29","2021-09-29","2021-09-29","2020-01-02","2021-08-31","2021-07-19","2022-11-17","2020-01-03","2020-01-03","2020-01-03","2021-09-29","2020-01-28","2020-12-29","2021-09-29","2021-09-29","2021-09-30","2022-02-20","2022-02-11","2022-02-11","2022-11-16","2020-10-19","2022-02-11","2021-04-28","2021-04-28","2022-02-20","2021-04-28","2022-02-20","2022-02-20","2022-02-20","2021-05-18","2021-11-07","2022-02-11","2022-02-21","2021-09-29","2021-08-31","2021-11-08","2020-08-09","2020-01-09","2020-03-21","2020-10-18","2021-05-18","2020-08-09","2021-03-27","2021-03-23","2021-03-23","2021-03-24","2021-03-27","2021-09-04","2021-09-29","2021-09-29","2020-03-23","2022-02-20","2020-12-19","2021-03-02","2022-08-04","2021-10-01","2021-11-07","2021-11-07","2020-03-20","2020-07-15","2022-11-16","2020-07-15","2020-07-15","2020-07-16","2020-07-16","2020-07-16","2020-07-16","2020-12-18","2021-09-12","2020-12-29","2021-04-30","2021-08-31","2021-09-30","2020-12-22","2021-05-20","2020-02-10","2020-02-10","2020-12-17","2021-11-10","2020-02-10","2020-07-15","2022-09-20","2019-03-01","2019-04-08","2019-04-08","2019-09-01","2019-12-03","2019-03-01","2019-06-26","2019-09-11","2019-09-11","2019-12-05","2019-06-26","2019-06-26","2019-06-26","2019-06-26","2019-06-26","2019-01-08","2019-12-30","2019-05-09","2019-05-09","2019-05-09","2019-01-22","2019-01-22","2019-02-11","2019-02-11","2019-05-31","2019-12-05","2019-01-08","2019-05-09","2022-07-14","2022-07-14","2022-02-20","2022-05-12","2022-08-04","2022-09-20","2022-06-25","2022-02-21","2022-02-20","2022-11-16","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":[["","00169633910","NOVOLOG","INJ FLEXPEN","30","Select","Select",""],["","00169255013","TRESIBA","INJ 200UNIT","9","Select","Select",""],["","72205001390","PREGABALIN","CAP 75MG","60","Select","Select",""],["","00002879959","HUMALOG","INJ 100\/ML","30","Select","Select",""],["","","INSULIN","INJ FLEXPEN","","Select","Select",""],["","08290320122","BD  PEN NEEDL","MIS 32GX4MM","200","Select","Select",""],["","00002803101","GLUCAGON","KIT 1MG","2","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","65162010211","GABAPENTIN","CAP 300MG","60","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","30","Select","Select",""],["","53885026701","ONETOUCH","KIT VERIO IQ","1","Select","Select",""],["","53885004401","ONE","KIT VERIO FL","1","Select","Select",""],["","27241009803","DULOXETINE","CAP 30MG","60","Select","Select",""],["","08627005303","DEXCOM","MIS SENSOR","9","Select","Select",""],["","","ARIPIPRAZOLE","TAB 2MG","","Select","Select",""],["","00002614511","BAQSIMI","POW 3MG\/DOSE","3","Select","Select",""],["","","KLOR-CON","TAB 20MEQ ER","","Select","Select",""],["","","POT  CL MICRO","TAB 20MEQ ER","","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","6","Select","Select",""],["","","MIRTAZAPINE","TAB 15MG","","Select","Select",""],["","68645048154","ATORVASTATIN","TAB 20MG","30","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","9","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","16714035101","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","53746017801","METFORMIN","TAB 500MG ER","120","Select","Select",""],["","","METRONIDAZOL","GEL 0.75%VAG","","Select","Select",""],["","","LANTUS","INJ 100\/ML","","Select","Select",""],["","","TUMS","CHW 1000MG","","Select","Select",""],["","","POT  CHLORIDE","TAB 20MEQ ER","","Select","Select",""],["","","K-TAB","TAB 20MEQ","","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","","MEDROXYPR","INJ 150MG\/ML","","Select","Select",""],["","00193288021","KETOSTIX","TES STRIP","100","Select","Select",""],["","","TRUEPLUS","CHW GLUCOSE","","Select","Select",""],["","","NYSTATIN","OIN 100000","","Select","Select",""],["","","GLUCOSE","CHW 4GM","","Select","Select",""],["","16714043901","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","68180089313","PIRMELLA","TAB 12785","28","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","4","Select","Select",""],["","08396901434","RELION","MIS 32GX4MM","200","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":{"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":""}]}]}