{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  HTENNEKSNIKTA R ","gend":0,"add":"SEROF 2145RD WEIV T","city":"PARTLOW","state":"VA","zip":"22534-9998","dob":"1958-10-17","age":"","mstatus":"","insh":"33200210*43","cliId":"","pno":"","cno":"","email":"","ename":"","eno":"","pphy":"WOODFORD, DANIEL W MD","ppno":"804\/633-5840","pcpadd":"121 COURTHOUSE LANE","pcpcity":"BOWLING GREEN","pcpstate":"VA","pcpzip":22427,"pcpcounty":"","pcpid":"","pcpname":"MARY WASHINGTON HEALTHCARE PHYSICIANS","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R53.1","Z45.02","R55.","I44.4","R07.9","E87.6","E83.31","K31.84","R10.13","G47.33","I10.","I49.3","I22.1","R94.31","R07.89","R40.4","R47.81","R41.0","K92.2","R11.10","Z20.822","R00.0","R11.2","J44.0","J18.9","K80.20","I25.10","E78.5","E78.00","I25.2","E10.43","E83.42","I95.9","R68.89","R68.81","Z95.5","R10.10","R63.4","G62.9","E11.9","H52.03","H25.13","H53.002","H52.203","H52.4","R19.7","K21.9","R06.00","E11.65","Z20.828","I69.354","T82.855A","G51.0","I11.0","I50.9","F41.9","J44.9","F10.10","E66.9","Z68.33","Z96.653","K52.9","R56.9","Z53.20","Z79.02","Z79.4","Z79.51","Z79.82","Z95.1","G40.909","G47.30","I25.5","I25.798","I65.23","K59.00","R41.82","R10.9","I67.2","I65.03","I70.8","R29.818","R09.89","I49.9","R11.11","I42.8","F12.188","F19.10","E04.1","M25.50","R29.898","R10.84","G81.90","R52.","R09.02","R42.","I63.212","I50.23","I63.9","E11.69","R45.1","Z86.73","Z87.891","D64.9","F17.200","Z86.16","U07.1","H61.21","H91.93","G45.9","G43.109","I21.4","R51.9","M79.662","R47.9","F32.9","R47.1","Z68.34","Z90.49","K63.5","K29.80","E87.2","R11.15","G93.41","E87.1","R74.01","I50.22","S90.812A","E10.9","Z96.652","Z82.49","Z83.3","S99.922A","I67.89","S90.32XA","W19.XXXA","Y92.89","Y93.89","R06.02","E16.1","E16.2","R40.20","R06.89","R69.","R10.30","I50.21","K29.70","K57.92","K29.00","R06.9","K44.9","Z12.11","J16.8","I24.9","D69.6","F12.90","H60.393","H61.23","I49.1","K74.60","R07.2","M25.562","Z23.","J44.1","V58.89","E11.8","I25.810","F03.90","E10.65","R73.9","R11.0","I49.8","I20.0","G43.909","I25.110","I69.954","E66.01","Z68.37","F40.240","I25.82","T82.837A","Z01.818","Z98.890","I50.20","Z86.718","Z79.01","Z98.61","M75.121","M65.9","Z95.810","I47.2","NO DATA","I50.42","E10.42","I49.01","F15.10","F14.10","T82.198A","Z72.0","I44.0","M51.36","J45.909","Z79.84","E13.9","G44.89","I48.0"],"date":["2022-04-21","2022-11-09","2022-11-09","2021-12-03","2021-12-04","2021-12-03","2021-12-03","2022-09-02","2021-10-17","2022-09-03","2022-10-12","2021-10-17","2020-12-15","2022-04-21","2022-09-02","2021-12-03","2022-04-21","2021-07-21","2021-01-17","2021-02-15","2021-10-12","2021-07-25","2021-10-17","2021-04-26","2021-04-26","2021-04-27","2022-09-26","2022-09-03","2022-09-02","2022-09-02","2022-09-02","2021-04-26","2021-04-28","2021-04-26","2021-04-26","2021-09-13","2021-04-27","2021-04-27","2022-09-26","2022-08-05","2020-06-17","2020-06-17","2020-06-17","2020-06-17","2020-06-17","2021-02-23","2022-08-05","2020-08-25","2022-04-21","2020-12-15","2021-07-25","2020-12-15","2020-11-03","2022-09-02","2021-10-17","2020-11-03","2022-09-02","2020-11-03","2021-07-25","2020-11-03","2022-02-15","2021-03-15","2021-12-03","2020-12-15","2021-04-14","2022-09-02","2022-04-21","2022-04-21","2022-04-21","2021-07-25","2020-12-22","2022-11-09","2022-11-09","2022-10-12","2021-03-16","2022-09-02","2021-07-11","2021-07-11","2021-07-11","2021-07-11","2021-07-11","2021-07-11","2022-09-02","2021-07-21","2021-12-04","2021-09-22","2021-09-22","2021-09-22","2020-10-26","2020-12-15","2021-10-17","2021-03-15","2021-12-03","2021-07-11","2022-04-21","2021-05-03","2022-09-26","2021-09-02","2021-09-01","2021-06-14","2022-04-21","2021-06-14","2021-07-25","2021-10-17","2021-10-17","2021-10-17","2020-05-22","2020-05-22","2021-09-02","2021-02-08","2022-09-08","2022-04-21","2021-07-22","2021-09-01","2021-07-25","2021-03-15","2021-03-15","2021-03-15","2021-03-18","2021-03-18","2021-04-16","2021-04-16","2021-07-11","2021-12-03","2021-07-11","2022-04-21","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-09-01","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2020-11-02","2021-01-16","2021-01-16","2021-05-28","2021-02-15","2021-02-23","2021-02-26","2021-04-16","2021-05-28","2021-05-28","2021-05-28","2020-11-07","2021-03-18","2021-03-18","2021-04-25","2021-07-25","2021-07-25","2021-07-25","2020-06-18","2020-06-18","2020-11-02","2021-04-14","2021-09-20","2019-04-01","2019-10-25","2019-01-31","2019-06-13","2019-02-22","2019-09-24","2019-09-24","2022-09-02","2022-04-21","2019-09-24","2019-12-07","2019-12-10","2019-04-09","2019-12-07","2019-05-27","2019-05-27","2019-05-27","2019-05-27","2022-09-02","2019-05-27","2019-03-15","2019-06-10","2019-12-07","2019-12-07","2019-12-07","2019-12-07","2019-03-04","2019-03-04","2022-10-29","2022-09-02","2022-11-09","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-09-26","2022-09-26","2022-04-21","2022-02-15","2022-04-21","2022-04-21","2022-09-03","2022-04-21","2022-11-09"],"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":[["","00186077760","BRILINTA","TAB 90MG","18","Select","Select",""],["","49348098053","SM","TAB 81MG EC","30","Select","Select",""],["","00093220301","METOCLOPRAM","TAB 10MG","90","Select","Select",""],["","00002751001","HUMALOG","INJ 100\/ML","10","Select","Select",""],["","69315011701","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","30","Select","Select",""],["","65162010250","GABAPENTIN","CAP 300MG","90","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","74312001380","VITAMIN","TAB 1000MCG","30","Select","Select",""],["","65862014205","CARVEDILOL","TAB 3.125MG","60","Select","Select",""],["","43547035210","LISINOPRIL","TAB 5MG","30","Select","Select",""],["","","NYSTATIN","CRE 100000","","Select","Select",""],["","","ASPIRIN","TAB 81MG EC","","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","43598044828","NICOTINE","DIS 21MG\/24H","28","Select","Select",""],["","43598043611","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","51862024160","AMIODARONE","TAB 200MG","90","Select","Select",""],["","55111012305","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","59651000305","OMEPRAZOLE","CAP 40MG","60","Select","Select",""],["","50428030716","CVS","TAB 81MG EC","30","Select","Select",""],["","00003089421","ELIQUIS","TAB 5MG","60","Select","Select",""],["","53885000810","ONETOUCH","MIS PLUS 33G","400","Select","Select",""],["","69315012710","FOLIC","TAB 1000MCG","30","Select","Select",""],["","66993006885","PANTOPRAZOLE","TAB 40MG","60","Select","Select",""],["","50742061701","METOPROL","TAB 100MG ER","30","Select","Select",""],["","55111053301","DIVALPROEX","TAB 250MG ER","30","Select","Select",""],["","68462026430","ROSUVASTATIN","TAB 40MG","30","Select","Select",""],["","31722070230","LOSARTAN","TAB 100MG","30","Select","Select",""],["","23155010405","METFORMIN","TAB 1000MG","60","Select","Select",""],["","08290328418","INSULIN","MIS 1ML\/31G","100","Select","Select",""],["","00378875006","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","69097012705","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","00093221001","SUCRALFATE","TAB 1GM","20","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","00591336905","BUT\/APAP\/CAF","TAB ","30","Select","Select",""],["","67877024901","QUETIAPINE","TAB 50MG","30","Select","Select",""],["","10572030201","PEG-3350\/KCL","SOL \/SODIUM","4000","Select","Select",""],["","42858066045","FENOFIBRATE","TAB 160MG","30","Select","Select",""],["","68382004001","PROMETHAZINE","TAB 12.5MG","15","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","10","Select","Select",""],["","","ISOSORB","TAB 10MG","","Select","Select",""],["","","ONDANSETRON","TAB 4MG ODT","","Select","Select",""],["","","DICYCLOMINE","TAB 20MG","","Select","Select",""],["","45802086866","POLYETH","POW 3350 NF","28","Select","Select",""],["","08290320109","BD  PEN NEEDL","MIS 31GX8MM","200","Select","Select",""],["","61269010534","BACITR","OIN 500UNIT","120","Select","Select",""],["","45802088096","NYSTAT\/TRIAM","CRE ","60","Select","Select",""],["","","TRULICITY","INJ 1.5\/0.5","","Select","Select",""],["","","WIXELA","AER 250\/50","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","DEXCOM","MIS SENSOR","","Select","Select",""],["","","DEBROX","SOL 6.5% OT","","Select","Select",""],["","","CORTISPORIN","","","Select","Select",""],["","","METOPROLOL","TAB 50MG ER","","Select","Select",""],["","","NEO\/POLY\/HC","SOL 1% OTIC","","Select","Select",""],["","","BP","KIT WRIST","","Select","Select",""],["","","DIPHEN\/ATROP","TAB 2.5MG","","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","10","Select","Select",""],["","","SEMGLEE","SOL 100U\/ML","","Select","Select",""],["","","EAR","DRO 0.065","","Select","Select",""],["","","LOPERAMIDE","CAP 2MG","","Select","Select",""],["","","OXYCOD\/APAP","TAB 10-325MG","","Select","Select",""],["","00173069600","ADVAIR","AER 250\/50","60","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","40","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","63481068447","VOLTAREN","GEL 0.01","100","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","00904770418","ASPIR-LOW","TAB 81MG EC","30","Select","Select",""],["","13107006001","APAP\/CODEINE","TAB 300-60MG","21","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","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":""}]}]}