{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DENA COX","gend":1,"add":"10367 COX LANE","city":"KING GEORGE                   ","state":"VA","zip":"22485-3443","dob":"1963-09-02","age":"","mstatus":"","insh":5663592,"cliId":"","pno":5406842137,"cno":"","email":"","ename":"","eno":"","pphy":"HARRINGTON, CHRISTOPHER","ppno":5407411667,"pcpadd":"6106 HEALTH CENTER LANE,","pcpcity":"FREDERICKSBURG                ","pcpstate":"VA","pcpzip":224076687,"pcpcounty":"","pcpid":"","pcpname":"HERITAGE HALL KING GEORGE","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"10367 COX LANE","add3":"","madd1":"10367 COX LANE","madd2":"","madd3":"","mcity":"KING GEORGE                   ","mstate":"VA","mzip":"22485-3443","pcpfaxno":"(540) 479-4205","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","R68.89","M19.071","M25.571","Z87.81","G89.29","Z98.1","J20.9","R05","M79.604","T84.84XA","Z96.9","M79.661","W19.XXXA","R21","M25.572","L03.818","E55.9","Z20.828","R51.9","R23.8","L03.115","Z20.822","Z11.3","J01.90","R30.0","N39.0","L98.8","T84.84XD","S82.831A","S82.301A","J30.89","F17.210","E86.0","R94.5","Z00.01","J02.9","L08.9","M79.644","M79.641","M25.531","S69.91XA","M13.841","Z91.09","Z86.19","M18.11","M86.471","M54.9","B18.9","B18.2","R53.83","M86.60","M86.671","J44.9","B35.4","R19.7","M54.5","F17.200","Z13.89","Z51.81","M86.161","B19.20","Z72.0","R06.00","R09.02","R00.0","R06.02","R07.89","J44.1","M86.8X7","J40","E66.3","Z71.9","G47.00","F10.10","K76.0","E83.110","M54.50","M54.31","I10","B85.1","L29.9","R05.9","R44.3","R44.2","L29.8","G47.8","F22","B85.0","F17.290","Z53.20","B76.9"],"date":["2021-12-28","2021-02-25","2020-01-14","2021-07-02","2021-06-08","2020-01-14","2020-01-14","2021-09-01","2021-09-16","2020-02-05","2020-02-20","2021-06-08","2020-03-27","2020-03-27","2021-03-18","2020-04-01","2020-04-01","2020-04-01","2020-06-25","2021-01-21","2020-12-03","2021-08-16","2021-09-04","2021-02-22","2021-07-16","2021-11-10","2021-11-10","2021-06-08","2021-02-23","2021-02-23","2021-09-16","2021-03-15","2021-11-15","2021-03-18","2021-09-27","2021-04-01","2021-04-01","2021-04-02","2021-04-29","2021-04-02","2021-04-14","2021-04-02","2021-04-05","2021-04-15","2021-09-27","2021-12-16","2021-06-08","2021-06-08","2021-06-16","2021-07-21","2021-06-16","2021-07-02","2021-07-02","2021-09-16","2021-11-19","2021-11-10","2021-07-21","2021-12-28","2021-12-28","2021-12-28","2021-09-01","2021-09-27","2021-09-01","2021-09-01","2021-09-01","2021-09-01","2021-09-04","2021-09-04","2021-09-04","2021-09-16","2021-09-17","2021-09-17","2021-09-17","2021-12-28","2021-09-27","2021-09-27","2021-09-27","2021-10-06","2021-10-06","2021-10-06","2021-11-26","2021-10-31","2021-10-31","2021-10-31","2021-10-31","2021-10-31","2021-11-10","2021-11-15","2021-11-15","2021-11-15","2021-11-15","2021-11-26"],"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":[]},{"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":[["","12496120803","SUBOXONE","MIS 8-2MG","70","Select","Select",""],["","65862048901","QUETIAPINE","TAB 25MG","28","Select","Select",""],["","75826011410","PHENAZOPYRID","TAB 100MG","18","Select","Select",""],["","43386009663","CLOBETASOL","OIN 0.0005","90","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","70710122501","AMITRIPTYLIN","TAB 10MG","28","Select","Select",""],["","49483060350","IBUPROFEN","TAB 600MG","15","Select","Select",""],["","00603533715","PREDNISONE","PAK 5MG","21","Select","Select",""],["","43547040011","CYCLOBENZAPR","TAB 10MG","21","Select","Select",""],["","00603188016","LIDOCAINE","PAD 0.05","10","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","60505025203","TIZANIDINE","TAB 4MG","10","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","00168025815","CLOTRIM\/BETA","CRE DIPROP","15","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","16714079904","CETIRIZINE","TAB 10MG","90","Select","Select",""],["","00378967130","IPRATROPIUM\/","SOL ALBUTER","90","Select","Select",""],["","59779030501","CLOTRIMAZOLE","CRE 0.01","14.2","Select","Select",""],["","69097073102","TERBINAFINE","TAB 250MG","14","Select","Select",""],["","21922002107","PERMETHRIN","CRE 0.05","60","Select","Select",""],["","50428178608","LICE","SHA 0.33-4%","236","Select","Select",""],["","43598075205","BUPROPION","TAB 150MG SR","60","Select","Select",""],["","69784050001","EC-NAPROXEN","TAB 500MG","14","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","28","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00603459315","METHYLPRED","TAB 4MG","21","Select","Select",""],["","45802008801","ALBUTEROL","AER HFA","8.5","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","135","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","90","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00597015561","STIOLTO","AER 2.5-2.5","4","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","480","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","14","Select","Select",""],["","00254200801","COLCHICINE","TAB 0.6MG","14","Select","Select",""],["","00536589688","NICOTINE","DIS 21MG\/24H","28","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","27","Select","Select",""],["","42799080601","IVERMECTIN","TAB 3MG","10","Select","Select",""],["","42806016005","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","6","Select","Select",""],["","00069047103","CHANTIX","PAK 0.5& 1MG","53","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","47781030801","NITROFUR","CAP 100MG","10","Select","Select",""],["","59779008001","ATHLETE","CRE 0.01","60","Select","Select",""],["","75834002001","VITAMIN","CAP 50000UNT","12","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}