{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YMMATSNIKDA","gend":1,"add":"DOOW 77641DAOR ENAL","city":"WOODFORD","state":"VA","zip":"22580-2927","dob":"1967-02-09","age":"","mstatus":"","insh":"13018467","cliId":"","pno":"4804525971","cno":"","email":"","ename":"","eno":"","pphy":"PASCOE, CARRIE L","ppno":8046335840,"pcpadd":"121 COURTHOUSE LN","pcpcity":"Bowling Green","pcpstate":"VA","pcpzip":"22427-9336","pcpcounty":"","pcpid":"","pcpname":"MARY WASHINGTON HEALTHCARE PHYSICIANS","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"14677 WOODLANE ROAD","add3":"","madd1":"14677 WOODLANE ROAD","madd2":"","madd3":"","mcity":"WOODFORD","mstate":"VA","mzip":"22580-2927","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R91.8","N89.8","R10.2","N95.0","R06.02","R05.9","C52","Z68.42","E66.9","E03.9","N18.9","M19.90","Z20.822","Z90.49","Z79.899","Z80.0","Z87.42","N85.8","N28.89","N20.0","K83.8","C80.1","M41.9","C53.9","R59.1","C53.0","N30.00","G89.3","C68.0","M06.9","Z87.442","Z79.890","Z79.891","Z45.2","R11.2","D70.1","D72.829","N30.01","C34.91","C34.92","R91.1","N39.0","C78.02","C78.01","C77.2","C77.5","C79.82","Z68.41","D84.821","E87.6","E83.42","T45.8X5A","C79.89","C54.1","K76.0","Z23","M25.511","R29.898","M75.121","A41.9","N18.32","C55","R65.20","Z68.39","K59.00","R50.9","R00.0","R07.9","R53.83","M25.512","R10.9","R94.5","E86.0","R53.0","R19.7","D84.9","B37.9","G89.4","Z88.6","Z86.19","Z68.37","Z85.42","A08.4","R06.82","M35.9","Z85.118","Z85.53","Z85.43","M19.011","M75.111","A04.72","Z68.36","C79.9","R11.10","R90.82","M75.01","R61","R68.83","E03.8","R68.89","R94.02","M47.812","S50.862A","W57.XXXA","M89.9","Z12.31","M75.52","M75.112","M67.814","R42","E66.01","M47.816","H81.10","J30.0","H81.12","R63.5","F11.90","D72.821","D72.820","C78.00","C34.90","E83.52","Z85.41","T82.598A","J98.4","E27.49"],"date":["2022-03-05","2021-12-15","2021-12-27","2021-12-15","2021-12-08","2021-12-08","2022-01-10","2021-12-15","2022-06-10","2023-03-16","2023-01-14","2021-12-15","2022-04-20","2023-02-09","2022-01-10","2021-12-13","2021-12-17","2021-12-14","2023-02-09","2022-08-08","2021-12-14","2022-01-17","2023-01-14","2023-03-14","2021-12-17","2021-12-30","2022-05-24","2022-05-10","2021-12-27","2022-05-10","2021-12-27","2022-04-20","2022-04-20","2023-01-20","2023-03-14","2022-12-20","2023-03-10","2022-01-17","2022-01-17","2022-01-17","2022-01-17","2023-03-10","2022-04-20","2022-04-20","2022-01-17","2022-01-17","2022-09-30","2022-01-17","2022-01-17","2022-06-10","2022-04-20","2022-01-17","2022-01-17","2022-03-05","2022-11-07","2022-12-20","2023-03-14","2022-04-10","2022-04-10","2022-05-12","2022-04-20","2022-04-20","2022-04-23","2022-04-20","2022-04-20","2022-04-20","2023-03-14","2022-04-20","2022-04-20","2023-03-14","2023-03-10","2023-03-10","2023-03-14","2023-03-14","2023-03-14","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2023-01-14","2022-05-24","2022-05-24","2022-05-24","2022-08-15","2022-05-24","2022-05-24","2022-06-05","2022-06-05","2022-06-10","2022-06-10","2023-01-14","2022-06-27","2022-06-27","2023-01-11","2022-12-20","2022-12-20","2023-03-15","2022-07-15","2022-07-23","2022-07-23","2022-08-02","2022-08-02","2022-08-15","2022-12-19","2023-01-11","2022-09-29","2022-09-29","2022-09-30","2022-09-30","2022-09-30","2022-10-25","2022-10-25","2022-10-25","2022-11-18","2022-11-15","2022-12-20","2022-12-20","2023-01-14","2023-01-14","2023-01-14","2023-01-14","2023-01-20","2023-02-09","2023-03-16"],"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":[]},{"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":[["","00406055201","OXYCODONE","TAB 5MG","120","Select","Select",""],["","69547035302","NARCAN","SPR","2","Select","Select",""],["","00904699880","DOCUSATE SOD","CAP 100MG","20","Select","Select",""],["","45802086802","POLYETH GLYC","POW 3350 NF","238","Select","Select",""],["","51293061201","PHENAZOPYRID","TAB 200MG","9","Select","Select",""],["","00143992801","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","65862018830","ONDANSETRON","TAB 8MG","30","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","30","Select","Select",""],["","50383066730","LIDO\/PRILOCN","CRE 2.5-2.5%","30","Select","Select",""],["","60258017101","MAG OXIDE","TAB 400MG","30","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","60","Select","Select",""],["","11877001140","BINAXNOW COV","KIT HOME TES","2","Select","Select",""],["","68462012605","GABAPENTIN","TAB 600MG","150","Select","Select",""],["","70710116201","MECLIZINE","TAB 25MG","30","Select","Select",""],["","69238183207","LEVOTHYROXIN","TAB 75MCG","30","Select","Select",""],["","42858080201","MORPHINE SUL","TAB 30MG ER","60","Select","Select",""],["","00054004641","IPRATROPIUM","SPR 0.0006","15","Select","Select",""],["","13811071910","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","64980033912","MAGNESIUM-OX","TAB 400MG","30","Select","Select",""],["","57237005920","CEFUROXIME","TAB 500MG","8","Select","Select",""],["","59762007401","HYDROCORT","TAB 10MG","75","Select","Select",""],["","64380071206","BENZONATATE","CAP 100MG","18","Select","Select",""],["","57237002801","AMOXICILLIN","TAB 500MG","15","Select","Select",""],["","68180016613","VANCOMYCIN","CAP 125MG","40","Select","Select",""],["","69452015120","VITAMIN D","CAP 50000UNT","4","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","30","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","59746011506","PROCHLORPER","TAB 10MG","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":""}]}]}