{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"R   IROLYAWANOC ","gend":1,"add":"IHSAW 37TS NOTGN","city":"LANCASTER","state":"VA","zip":"22503-9998","dob":"1963-08-27","age":"","mstatus":"","insh":"65200210*98","cliId":"","pno":"64\/4081080-6","cno":"804\/296-0587","email":"","ename":"","eno":"","pphy":"ASHWORTH, JOEL MD","ppno":"804\/435-2651","pcpadd":"402 NORTH MAIN STREET","pcpcity":"KILMARNOCK","pcpstate":"VA","pcpzip":22482,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS KILMARNOCK PRIMARY CARE","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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R35.0","Z11.3","N89.8","M25.562","M54.12","M54.16","M62.838","M89.49","H00.15","F31.81","Z20.828","N39.0","R10.32","M25.552","M54.5","M54.2","M25.512","M16.12","Z47.1","J45.909","F17.210","Z96.642","Z79.82","G89.29","E66.01","M70.62","Z68.34","F43.12","Z01.818","R10.9","R63.4","Z68.35","J31.0","J45.21","F17.200","R42.","Z68.36","M54.9","M70.61","G56.02","M75.42","R29.6","R35.1","R33.9","N30.20","J01.90","R05.","J01.91","R06.02","J30.9","F17.209","Z01.419","R39.15","Z13.820","B37.3","R68.89","Z13.21","R39.9","R10.2","H81.11","R68.83","J02.9","Z20.822","K21.9","M21.6X2","M21.6X1","M77.51","M20.42","M20.41","M20.10","L02.91","N95.0","A59.00","R82.90","J01.00","Z01.411","R73.03","E78.2","E66.9","N81.10","M62.9"],"date":["2021-08-31","2021-07-14","2021-07-14","2021-12-15","2020-12-09","2020-12-09","2020-12-09","2021-09-08","2020-12-09","2021-11-08","2020-12-22","2021-04-20","2021-02-08","2021-10-25","2021-08-19","2021-08-19","2021-08-19","2021-10-26","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-11-03","2021-01-12","2021-07-21","2021-01-12","2021-04-14","2021-10-21","2021-10-26","2020-01-17","2020-01-17","2020-01-17","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-08-06","2021-07-29","2021-08-25","2021-07-29","2021-07-29","2021-08-06","2021-08-24","2021-08-31","2021-08-24","2020-09-22","2020-12-21","2020-11-23","2020-12-26","2021-04-14","2021-04-14","2020-08-10","2020-08-10","2020-08-10","2020-11-20","2020-11-20","2021-10-08","2021-12-15","2021-12-15","2021-07-23","2020-12-21","2020-12-21","2021-12-22","2019-01-02","2019-11-25","2019-11-25","2019-11-25","2019-11-25","2019-11-25","2019-11-25","2019-11-25","2019-04-26","2019-04-26","2019-10-24","2019-10-24","2019-01-02","2019-01-02","2019-01-02","2019-01-02","2019-01-02","2019-04-26"],"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":[["","13668021630","ARIPIPRAZOLE","TAB 2MG","30","Select","Select",""],["","16714089803","LORATADINE","TAB 10MG","30","Select","Select",""],["","59746012106","MECLIZINE","TAB 25MG","30","Select","Select",""],["","49035037730","EQ","TAB 8.6-50MG","30","Select","Select",""],["","49035061246","ALLERGY","TAB 10MG","30","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","65162019011","NAPROXEN","TAB 500MG","60","Select","Select",""],["","65162037310","OXYBUTYNIN","TAB 15MG ER","10","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00093317431","ALBUTEROL","AER HFA","8","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","68382005105","MELOXICAM","TAB 15MG","30","Select","Select",""],["","00832153011","HALOPERIDOL","TAB 2MG","30","Select","Select",""],["","62332014131","CELECOXIB","CAP 100MG","60","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","42","Select","Select",""],["","00280211010","BAYER","TAB 325MG EC","45","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","31722099601","HYDROCO\/APAP","TAB 5-325MG","28","Select","Select",""],["","","GABAPENTIN","TAB 600MG","","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","","QUETIAPINE","TAB 25MG","","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","4","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","1","Select","Select",""],["","70677007101","SM","TAB 325MG EC","34","Select","Select",""],["","65862042001","SMZ\/TMP","TAB 800-160","14","Select","Select",""],["","69367016304","PHENAZOPYRID","TAB 200MG","9","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00185012201","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","00135019502","NICODERM","DIS 14MG\/24H","28","Select","Select",""],["","31722077705","ACYCLOVIR","TAB 400MG","90","Select","Select",""],["","00168025846","CLOTRIM\/BETA","CRE DIPROP","30","Select","Select",""],["","00591544310","PREDNISONE","TAB 20MG","30","Select","Select",""],["","16714049401","AMOX\/K","TAB 500-125","30","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","65162025350","RANITIDINE","TAB 150MG","60","Select","Select",""],["","55111028130","LEVOFLOXACIN","TAB 750MG","5","Select","Select",""],["","00904505359","SUDOGEST","TAB 30MG","80","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","00054004641","IPRATROPIUM","SPR 0.0006","15","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","69452014430","BENZONATATE","CAP 200MG","21","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":""}]}]}