{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"VARINA   A SCHROEDER","gend":1,"add":"142 SILVER COURT","city":"MAURERTOWN","state":"VA","zip":"22644-2697","dob":"1979-05-31","age":"","mstatus":"","insh":4453148,"cliId":"","pno":5405397100,"cno":"","email":"","ename":"","eno":"","pphy":"HOLTHUS, THOMAS E","ppno":5404653751,"pcpadd":"33674 Old Valley Pike, ","pcpcity":"Strasburg","pcpstate":"VA","pcpzip":226573704,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"142 SILVER COURT","madd2":"","madd3":"","mcity":"MAURERTOWN","mstate":"VA","mzip":"22644-2697","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R68.83","R07.9","B34.9","S61.011A","W26.0XXA","R10.9","R50.9","R11.2","K21.9","I10","J01.90","R05","J02.9","B96.89","W54.0XXA","E46","E87.6","F10.11","K76.0","R16.0","Z13.220","Z86.79","Z87.448","E78.5","E55.9","F41.9","K58.0","K44.9","K70.10","F31.9","Z01.89","F31.0","M89.8X1","M79.18","M47.812","M54.2","M25.511","R10.11","Z98.84","R93.3","K80.20","K80.10","Z98.890","Z87.19","K43.2","G47.33","M19.90","F31.60","Z98.51","Z88.2","Z88.1","Z88.0","K91.89","M51.36","M54.5","D64.9","E83.51","R10.84","Z90.49","M25.572","Z04.3","S99.912A","R00.2","E61.1","M25.512","M79.602","M79.601","M25.562","X50.0XXA","M79.662","M65.872","M84.375A","J34.89","S92.015D","X50.0XXD","R59.0","M79.645","S69.92XA","M20.002","L03.012","M79.642","S62.663A","W23.0XXA","K85.20","K83.8","M22.2X2","M48.061","Z13.820","M85.88","T07.XXXA","M85.80","M85.851","M85.852","M51.37","M25.862","R60.0","M89.8X6","M17.12","M25.561","E83.42","R07.89","Z99.89","I51.7","R01.1","M62.838","M79.89","R55","R51","M79.10","Z86.718","I83.893","I15.9","Z86.19","R42","Z03.89","D53.9","I87.2","K04.7","Z72.0","J45.20","F32.9","Z01.419","R10.32","N83.202","Z97.5","Z98.891","S92.302A","S92.355A","M79.672","S99.922A","W01.0XXA","S92.355D","R21","Z01.84","Z20.828","R19.7","R11.0","R53.83","N32.89","R63.5","R07.81","R07.2","R30.0","R06.02","R10.12","R79.89","D72.819","Z09","F34.81","Z79.899","R41.3","G47.9","G47.52","G47.19","G43.919","Z12.31","I78.1","R74.8","S92.355K","R94.5","Z94.5","Z01.818","R93.89","N76.0","M84.375K","Z91.5","J45.909","G43.909","S92.352K","S93.326D","S93.322A","J20.9","M54.6","R04.2","F41.1","M51.34","G89.29","R61","R53.82","D72.829","Z11.1","D50.9","D75.89","M76.52","Z20.818","Z20.822","J40","M79.661","F31.12","E53.8","S62.647A","Z23","S62.647D","N64.4","N63.11","J06.9","R09.81","B97.89","N61.0","N60.12","N63.42","N64.52","N60.02","R10.10","K82.8","Z87.891","R63.0","R10.13","K59.1","N91.5","N93.0","Z01.812","Z30.430","N92.0","R23.4","Z87.898","Z86.69","R00.0","R25.1","S86.812A","X58.XXXA","K13.79"],"date":["2020-01-04","2020-10-21","2020-01-10","2020-01-07","2020-01-07","2020-10-21","2021-09-08","2020-08-05","2020-05-16","2022-02-08","2020-01-16","2021-09-08","2021-09-10","2020-01-16","2020-01-16","2020-01-30","2020-08-08","2020-11-19","2021-07-12","2020-01-30","2020-01-30","2020-01-30","2020-01-30","2020-02-27","2021-03-16","2021-03-16","2020-02-27","2020-01-30","2020-01-30","2021-03-16","2020-01-30","2022-03-11","2020-02-12","2021-07-09","2020-02-13","2020-10-23","2020-02-14","2020-05-16","2022-02-08","2020-05-16","2020-02-27","2020-02-27","2020-03-10","2022-02-08","2020-02-27","2022-02-18","2020-02-27","2020-08-07","2020-02-27","2020-02-27","2021-03-16","2021-03-16","2020-02-27","2020-07-21","2020-06-22","2020-10-26","2020-03-10","2020-11-19","2021-03-16","2020-04-21","2020-03-23","2020-03-23","2020-04-23","2020-08-07","2020-06-22","2020-06-22","2020-06-22","2022-01-23","2020-04-15","2020-04-20","2020-04-21","2020-04-21","2020-04-23","2020-05-11","2020-04-27","2022-03-25","2020-05-27","2020-05-08","2020-05-08","2020-05-08","2022-02-09","2020-05-11","2020-05-27","2020-05-16","2020-05-16","2020-06-03","2020-06-09","2020-06-16","2020-06-16","2020-08-07","2020-06-18","2021-08-27","2021-08-27","2020-07-21","2020-07-21","2020-10-26","2020-07-21","2020-07-21","2020-07-28","2020-08-07","2020-08-05","2020-08-05","2020-08-14","2020-08-14","2020-08-07","2020-08-10","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-08","2020-08-10","2020-12-04","2021-02-03","2020-08-28","2020-09-02","2020-09-02","2020-09-02","2021-11-16","2020-10-06","2020-10-06","2020-10-06","2020-10-06","2020-10-15","2021-03-16","2020-10-16","2020-10-15","2020-10-15","2020-12-30","2021-07-11","2020-10-19","2021-03-12","2020-10-21","2020-10-21","2020-11-19","2020-10-21","2020-10-21","2020-10-21","2020-10-23","2020-10-23","2021-06-11","2020-10-26","2021-01-04","2021-07-09","2022-01-25","2020-11-10","2022-01-25","2022-02-18","2020-11-19","2020-11-20","2022-02-18","2020-11-20","2021-12-16","2020-11-30","2021-03-03","2021-03-05","2021-01-04","2021-01-04","2021-01-04","2021-01-26","2021-02-01","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2021-04-30","2021-04-30","2021-04-30","2021-06-11","2021-07-09","2021-06-11","2021-06-24","2021-07-09","2021-07-05","2021-08-27","2021-06-28","2021-06-25","2021-06-28","2021-08-27","2021-08-27","2021-08-03","2021-08-27","2021-09-08","2021-09-10","2022-01-23","2022-01-25","2022-02-08","2022-03-11","2022-03-10","2022-03-11","2022-03-25","2022-03-25","2019-01-15","2019-01-15","2019-01-15","2019-01-25","2019-01-28","2019-02-01","2019-02-01","2019-02-01","2019-02-12","2019-02-12","2019-02-07","2019-02-12","2019-03-21","2019-02-11","2019-02-19","2019-04-10","2019-04-30","2019-04-30","2019-04-30","2019-07-09","2019-08-09","2019-08-09","2019-09-13","2019-09-13","2019-11-18","2019-11-18","2019-12-04"],"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":[["","00591544305","PREDNISONE","TAB 20MG","10","Select","Select",""],["","64380078706","BUSPIRONE","TAB 7.5MG","90","Select","Select",""],["","00093506105","HYDROXYZ","TAB 25MG","60","Select","Select",""],["","62332004060","LAMOTRIGINE","TAB 200MG","30","Select","Select",""],["","61874016030","VRAYLAR","CAP 6MG","30","Select","Select",""],["","60505006501","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","51224001050","BENZONATATE","CAP 100MG","30","Select","Select",""],["","68180037703","LOSARTAN","TAB 50MG","30","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","40","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","14","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","200","Select","Select",""],["","52817033010","CYCLOBENZAPR","TAB 5MG","15","Select","Select",""],["","65862019401","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","00574050801","FERROUS","TAB 324MG","30","Select","Select",""],["","65862001905","CEPHALEXIN","CAP 500MG","40","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","150","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","00000000000",""," ","420","Select","Select",""],["","13107001401","GLYCOPYRROL","TAB 1MG","60","Select","Select",""],["","68382091634","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00781808926","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00245036001","KLOR-CON","PAK 20MEQ","30","Select","Select",""],["","69543013611","TRAMADOL","TAB 50MG","28","Select","Select",""],["","45802071708","TERCONAZOLE","SUP 80MG","3","Select","Select",""],["","65862018830","ONDANSETRON","TAB 8MG","15","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","00378668977","PANTOPRAZOLE","TAB 40MG","15","Select","Select",""],["","65162006205","SUCRALFATE","SUS 1GM\/10ML","420","Select","Select",""],["","51862094205","DIAZEPAM","TAB 5MG","2","Select","Select",""],["","00406012305","HYDROCO\/APAP","TAB 5-325MG","15","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","65162003311","APAP\/CODEINE","TAB 300-30MG","4","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","20","Select","Select",""],["","57237000830","MIRTAZAPINE","TAB 15MG","30","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","10702000350","PROMETHAZINE","TAB 25MG","12","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","14","Select","Select",""],["","68382080601","TRAZODONE","TAB 100MG","30.00","Select","Select",""],["","68462019005","NAPROXEN","TAB 500MG","21","Select","Select",""],["","11822317640","RA","TAB 325MG","40","Select","Select",""],["","68462069497","FROVATRIPTAN","TAB 2.5MG","12","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","58914017014","CARAFATE","SUS 1GM\/10ML","1,200.00","Select","Select",""],["","50419042301","MIRENA","IUD SYSTEM","1","Select","Select",""],["","53746014501","HYDROCOD\/IBU","TAB 7.5-200","20","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","74312007373","EVE","CAP 1000MG","60","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":""}]}]}