{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA BAUSERMAN","gend":1,"add":"PO BOX 262","city":"STRASBURG                     ","state":"VA","zip":"22657-0262","dob":"1959-03-08","age":"","mstatus":"","insh":4373919,"cliId":"","pno":5404651314,"cno":5402071956,"email":"","ename":"","eno":"","pphy":"DRESSLER, WILLIAM C","ppno":5406350848,"pcpadd":"33674 Old Valley Pike,","pcpcity":"Strasburg                     ","pcpstate":"VA","pcpzip":226573704,"pcpcounty":"","pcpid":"","pcpname":"VALLEY HEALTH SHENANDOAH MEMORIAL HOSPITAL FAMILY","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":"","add2":"PO BOX 262","add3":"","madd1":"PO BOX 262","madd2":"","madd3":"","mcity":"STRASBURG                     ","mstate":"VA","mzip":"22657-0262","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K21.9","K44.9","G25.0","R11.2","R07.89","R14.0","Z12.11","D12.3","F17.210","D12.5","Z88.6","Z88.2","I10","Z90.49","Z82.49","K22.70","K22.8","K63.5","Q43.9","R68.89","Z01.419","Z80.41","J44.9","F31.9","I73.9","Z12.31","E66.01","Z68.36","N85.8","N89.8","M19.021","M25.511","M19.011","M25.521","B37.0","N64.89","M25.531","R20.0","M77.11","R20.2","M79.622","R06.02","R07.9","F17.200","I83.811","I87.2","L82.1","D22.5","D22.62","D22.61","L81.4","K21.00","Z72.0","Z68.37","E78.5","R31.9","R10.84","R10.10","R19.7","K76.0","J43.9","J98.11","R31.0","R10.2","R82.90","M79.641","N32.81","R31.29","I70.203","S99.911A","S16.1XXA","M25.571","S93.491A","X50.0XXA","S93.491D","M54.2","R22.1","R94.31","Z12.2","R06.83","J38.1","R91.8","R05","M65.321","R25.1"],"date":["2021-09-07","2021-03-15","2020-01-14","2020-01-14","2020-07-03","2020-01-14","2020-01-14","2020-01-14","2021-09-16","2020-01-14","2020-01-14","2020-01-14","2021-12-17","2020-01-14","2020-01-14","2020-01-14","2020-01-14","2020-01-14","2020-01-14","2020-03-16","2020-02-07","2020-02-20","2021-09-16","2021-12-02","2021-12-02","2021-09-02","2021-03-15","2020-02-11","2020-02-20","2020-02-20","2020-03-04","2020-03-04","2021-07-27","2020-03-04","2021-09-07","2020-03-16","2020-06-17","2020-06-17","2020-06-17","2020-06-17","2020-07-03","2021-09-16","2021-12-17","2021-12-02","2020-10-01","2021-07-12","2020-10-06","2020-10-06","2020-10-06","2020-10-06","2020-10-06","2020-10-15","2021-06-21","2020-10-15","2021-12-17","2021-03-15","2021-04-28","2021-04-12","2021-04-12","2021-04-12","2021-04-12","2021-04-12","2021-04-15","2021-04-15","2021-12-02","2021-06-23","2021-06-21","2021-06-21","2021-07-01","2021-07-12","2021-07-23","2021-07-27","2021-07-27","2021-07-27","2021-07-27","2021-09-02","2021-08-30","2021-12-17","2021-09-16","2021-09-02","2021-09-07","2021-09-16","2021-09-16","2021-11-17","2021-12-02"],"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":[["","68382009810","PAROXETINE","TAB 20MG","90","Select","Select",""],["","00378395305","ATORVASTATIN","TAB 80MG","30","Select","Select",""],["","68462029817","CLOTRIM\/BETA","CRE DIPROP","15","Select","Select",""],["","13668000801","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","68180052002","LISINOP\/HCTZ","TAB 20-25MG","90","Select","Select",""],["","00143993905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","63304073530","ESOMEPRA","CAP 40MG DR","30","Select","Select",""],["","27808023302","DOXYCYCL","CAP 100MG","28","Select","Select",""],["","51672136001","ACYCLOVIR","OIN 0.05","15","Select","Select",""],["","00527411837","PROPRANOLOL","CAP 120MG ER","90","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0.25","Select","Select",""],["","00069047103","CHANTIX","PAK 0.5& 1MG","53","Select","Select",""],["","33332032101","AFLURIA","INJ 2021-22","0.5","Select","Select",""],["","58160082311","SHINGRIX","INJ 50\/0.5ML","1","Select","Select",""],["","00378668999","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","70954005920","PREDNISONE","TAB 10MG","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","10","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","6","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","12","Select","Select",""],["","66689000816","NYSTATIN","SUS 100000","360","Select","Select",""],["","00006483703","PNEUMOVAX","INJ 25\/0.5","0.5","Select","Select",""],["","70461032003","FLUCLVX","INJ 2020-21","0.5","Select","Select",""],["","70700026330","LANSOPRAZOLE","CAP 30MG DR","30","Select","Select",""],["","16571020150","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","64764017530","DEXILANT","CAP 60MG DR","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":""}]}]}