{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ANNEKCMYELRUH K","gend":1,"add":"LP 21131RD NOOTA","city":"Spotsylvania","state":"VA","zip":"22551-9998","dob":"2000-06-22","age":"","mstatus":"","insh":"10114347","cliId":"","pno":"6304554851","cno":"","email":"","ename":"","eno":"","pphy":"STINAR, THERON R","ppno":5407858500,"pcpadd":"1129 HEATHERSTONE DR,","pcpcity":"Fredericksburg","pcpstate":"VA","pcpzip":"22407-4828","pcpcounty":"","pcpid":"","pcpname":"FREDERICKSBURG CHRISTIAN HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"13112 PLATOON DR","madd2":"","madd3":"","mcity":"Spotsylvania","mstate":"VA","mzip":"22551-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["A41.9","R51.9","R29.818","I49.8","Z33.1","Z3A.00","Z79.899","M25.551","Z47.89","S73.191D","M25.552","Q79.60","Z48.89","M24.152","M54.51","M25.561","M25.562","G89.4","O26.892","R10.30","O10.912","Z3A.24","O26.893","R10.2","M54.9","O99.613","O10.913","Z3A.35","Z90.49","O99.892","N89.8","Z3A.30","Z88.6","Z88.5","Z88.0","Z82.49","Z83.438","M25.851","M25.859","M35.7","D89.40","M25.50","F41.9","F32.A","G90.A","Z34.83","Z36.85","Z36.2","O99.810","S46.812A","G25.89","Z34.82","Z3A.20","M21.851","Z96.641","Z96.698","R25.2","S82.152A","O26.852","Z3A.17","M25.312","Z45.2","F41.8","E66.9","Z68.34","G43.701","Z47.2","M22.12","G43.019","K31.84","Z68.32","Z79.891","K21.9","Z3A.32","O09.891","D72.829","R42","Z20.828","R50.9","N61.0","R00.0","Z98.890","E86.1","Z3A.34","M25.512","I95.1","M54.16","M54.17","M72.2","M79.671","M79.672","S93.601A","S82.102K","R06.02","R07.9","G90.9","I10","G43.709","Z53.9","G89.29","Z79.82","B37.3","B00.1","O26.853","M25.852","Z20.822","R10.9","M24.151","Z74.3","O99.891","Z86.718","N30.00","N76.0","Z11.3","E87.2","Q65.00","Z3A.39","Z37.0","M54.50","M25.559","R35.0","Z3A.26","O34.219","B07.0","G44.211","R39.198","Z30.40","Z34.81","Z3A.08","E04.0","R07.89","Z87.09","Q79.69","Z36.87","O09.893","Z36.3","O69.81X0","O09.93","Z01.419","Z11.51","M16.0","R65.20","Z36.82","Z3A.12","O10.919","G43.711","E04.9","Z86.79","K31.89","M24.159","Z09","R01.0","K29.00","R10.84","O47.03","R11.0","O99.413","O09.892","Z36.86","Z3A.18","Z13.79","Z84.81","M22.8X2","O26.851","O71.9","W10.8XXA","Z3A.15","S82.153A","Z34.03","Z3A.37","U07.1","M46.1","Z39.2","Z30.011","F53.0","G89.18","Q79.62","E78.72","H66.002","M47.812","M22.8X1","T75.3XXA","G43.909","Z3A.36","R11.10","O23.12","B96.89","Z3A.16","Z23","O90.6","Z12.4","Z12.39","R82.90","Z32.01","O13.9","Z37.9","G90.1","O23.43","N39.0","Z3A.25","S83.002A","M25.569","Z68.31","X58.XXXA","I11.9"],"date":["2022-04-11","2022-03-03","2023-06-16","2022-07-21","2021-06-22","2022-01-18","2023-05-30","2022-11-11","2023-06-15","2021-05-17","2021-05-17","2023-05-09","2021-05-17","2021-05-17","2022-12-06","2022-12-06","2023-06-15","2023-05-30","2022-01-20","2022-01-20","2022-01-20","2022-01-20","2022-01-20","2022-01-20","2022-03-03","2022-01-20","2021-12-27","2021-12-27","2021-12-27","2022-01-20","2021-11-15","2021-11-22","2021-12-06","2023-05-30","2023-05-30","2022-07-18","2021-12-06","2022-11-11","2022-11-11","2021-11-09","2022-03-03","2021-11-09","2023-01-03","2023-01-03","2023-05-30","2022-01-12","2021-12-29","2021-12-29","2021-12-29","2022-04-05","2022-04-05","2021-10-06","2021-09-08","2022-06-21","2022-06-21","2022-06-21","2021-10-11","2021-03-08","2021-10-21","2021-08-18","2022-04-01","2022-11-28","2023-05-30","2023-05-30","2022-11-28","2022-11-28","2023-01-03","2023-05-30","2023-05-30","2023-01-03","2023-01-03","2023-05-30","2022-03-08","2021-12-06","2021-08-26","2022-04-25","2022-03-03","2022-03-03","2022-03-03","2022-03-05","2022-03-03","2023-06-15","2021-03-04","2021-12-15","2022-03-25","2022-09-29","2022-09-07","2022-09-07","2022-09-28","2022-09-28","2022-09-28","2021-03-17","2021-04-06","2022-07-18","2022-07-18","2021-09-07","2022-07-18","2021-05-06","2021-05-20","2021-05-20","2021-05-20","2022-03-08","2022-03-03","2021-11-22","2022-03-14","2022-05-15","2022-11-11","2022-11-11","2022-03-03","2021-12-06","2022-07-18","2021-09-27","2022-01-14","2022-06-29","2022-03-04","2022-01-18","2022-01-20","2022-01-18","2021-10-21","2021-10-21","2021-10-21","2021-10-21","2022-03-03","2022-09-28","2022-03-24","2021-07-06","2021-05-19","2021-06-16","2021-06-16","2021-06-16","2022-07-18","2022-07-18","2022-04-20","2021-06-15","2021-11-18","2021-09-07","2022-01-20","2021-12-01","2022-06-29","2022-06-29","2022-03-14","2022-03-05","2021-07-15","2021-07-15","2021-07-15","2022-06-08","2022-06-08","2022-07-18","2022-07-18","2022-06-23","2022-03-08","2022-03-08","2022-03-08","2022-01-19","2021-12-28","2021-12-28","2021-12-22","2021-08-26","2021-08-26","2021-08-26","2021-07-15","2021-07-15","2021-05-12","2021-07-06","2021-08-04","2021-08-04","2021-08-04","2021-03-08","2022-01-05","2022-01-05","2022-05-20","2021-08-12","2022-03-08","2022-03-08","2022-03-08","2023-05-30","2021-11-18","2021-11-18","2022-05-24","2022-03-03","2021-05-12","2022-06-24","2022-06-24","2021-12-28","2022-02-24","2021-10-11","2021-10-11","2021-08-11","2022-10-19","2022-03-25","2022-06-29","2022-06-29","2021-05-28","2021-05-28","2022-01-18","2022-01-18","2022-11-21","2021-12-26","2021-12-26","2021-10-21","2023-05-30","2023-06-15","2023-05-30","2023-05-30","2023-05-30"],"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":[]},{"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":[["","68462064693","ASHLYNA","TAB ","91","Select","Select",""],["","62332014131","CELECOXIB","CAP 100MG","60","Select","Select",""],["","68382003616","VENLAFAXINE","CAP 150MG ER","90","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","30","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","42806015905","HYDROXYZ HCL","TAB 10MG","90","Select","Select",""],["","64380078706","BUSPIRONE","TAB 7.5MG","60","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","50742050504","SCOPOLAMINE","DIS 1MG\/3DAY","10","Select","Select",""],["","42571017701","PIROXICAM","CAP 20MG","30","Select","Select",""],["","27241009903","DULOXETINE","CAP 60MG","60","Select","Select",""],["","70436005901","BUPROPION","TAB 150MG SR","180","Select","Select",""],["","71930005552","APAP\/CODEINE","TAB 300-30MG","21","Select","Select",""],["","50383066730","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","13668000905","CITALOPRAM","TAB 10MG","30","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","68462053670","IMIQUIMOD","CRE 0.05","24","Select","Select",""],["","69097015907","MELOXICAM","TAB 15MG","30","Select","Select",""],["","58160084252","BOOSTRIX","INJ ","0.5","Select","Select",""],["","00093220401","METOCLOPRAM","TAB 5MG","30","Select","Select",""],["","00555904358","APRI","TAB ","84","Select","Select",""],["","24510005010","NUCYNTA","TAB 50MG","21","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","42858030101","HYDROMORPHON","TAB 2MG","10","Select","Select",""],["","65862001905","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","49884012201","LABETALOL","TAB 100MG","180","Select","Select",""],["","00378728590","LEVONOR\/ETHI","TAB ESTRADIO","91","Select","Select",""],["","00781707787","METRONIDAZOL","GEL 0.75%VAG","70","Select","Select",""],["","00378427693","VALACYCLOVIR","TAB 1GM","12","Select","Select",""],["","51672404801","CLOTRIM\/BETA","CRE DIPROP","15","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","00069108530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","42806015905","HYDROXYZ","TAB 10MG","90","Select","Select",""],["","68462064693","ASHLYNA TAB","","91","Select","Select",""],["","62332014131","CELECOXIB CAP","100MG","60","Select","Select",""],["","68382003616","VENLAFAXINE CAP","150MG ER","90","Select","Select",""],["","59746011506","PROCHLORPER TAB","10MG","30","Select","Select",""],["","68180016011","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","42806015905","HYDROXYZ HCL TAB","10MG","90","Select","Select",""],["","64380078706","BUSPIRONE TAB","7.5MG","60","Select","Select",""],["","47781030301","NITROFURANTN CAP","100MG","10","Select","Select",""],["","70710113908","FLUCONAZOLE TAB","150MG","1","Select","Select",""],["","50742050504","SCOPOLAMINE DIS","1MG\/3DAY","10","Select","Select",""],["","42571017701","PIROXICAM CAP","20MG","30","Select","Select",""],["","27241009903","DULOXETINE CAP","60MG","60","Select","Select",""],["","70436005901","BUPROPION TAB","150MG SR","180","Select","Select",""],["","71930005552","APAP\/CODEINE TAB","300-30MG","21","Select","Select",""],["","50383066730","LIDO\/PRILOCN CRE","2.5-2.5%","30","Select","Select",""],["","13668000905","CITALOPRAM TAB","10MG","30","Select","Select",""],["","00093031401","KETOROLAC TAB","10MG","20","Select","Select",""],["","52817033010","CYCLOBENZAPR TAB","5MG","30","Select","Select",""],["","68462053670","IMIQUIMOD CRE","5%","24","Select","Select",""],["","13811071530","VENLAFAXINE TAB","225MG ER","30","Select","Select",""],["","69097015907","MELOXICAM TAB","15MG","30","Select","Select",""],["","58160084252","BOOSTRIX INJ","","0.5","Select","Select",""],["","00093220401","METOCLOPRAM TAB","5MG","30","Select","Select",""],["","00555904358","APRI TAB","","84","Select","Select",""],["","24510005010","NUCYNTA TAB","50MG","21","Select","Select",""],["","69547035302","NARCAN SPR","","2","Select","Select",""],["","42858030101","HYDROMORPHON TAB","2MG","10","Select","Select",""],["","65862001905","CEPHALEXIN CAP","500MG","28","Select","Select",""],["","49884012201","LABETALOL TAB","100MG","180","Select","Select",""],["","00378728590","LEVONOR\/ETHI TAB ESTRADIO","","91","Select","Select",""],["","50111033402","METRONIDAZOL TAB","500MG","14","Select","Select",""],["","00378427693","VALACYCLOVIR TAB","1GM","12","Select","Select",""],["","00781707787","METRONIDAZOL GEL","0.75%VAG","70","Select","Select",""],["","51672404801","CLOTRIM\/BETA CRE DIPROP","","15","Select","Select",""],["","00172572860","FAMOTIDINE TAB","20MG","60","Select","Select",""],["","00069108530","PAXLOVID TAB","300-100","30","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":""}]}]}