{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SONYA   Y STROTHERS","gend":1,"add":"1109   FARRISH PLACE                                        ","city":"FREDERICKSBURG                ","state":"VA","zip":"22401-2678","dob":"1977-12-19","age":"","mstatus":"","insh":6859172,"cliId":"","pno":5403764886,"cno":"","email":"","ename":"","eno":"","pphy":"ANBESSIE, TEDLA B                                           ","ppno":5406579191,"pcpadd":"2146 Jefferson Davis Hwy                                    ,Ste 101                                                     ","pcpcity":"Stafford                      ","pcpstate":"VA","pcpzip":225547223,"pcpcounty":"","pcpid":"","pcpname":"AQUIA FAMILY MEDICAL CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"CENTRAL","aligned":"","ano":"","add2":"1109   FARRISH PLACE                                        ","add3":"","madd1":"1109   FARRISH PLACE                                        ","madd2":"                                                            ","madd3":"","mcity":"FREDERICKSBURG                ","mstate":"VA","mzip":"22401-2678","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","1","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E66.9","Z68.33","Z46.51","J93.83","R06.02","J43.9","J93.11","R91.8","N91.1","N93.9","K59.00","Z79.51","Z87.09","Z98.84","Z87.891","Z82.5","Z82.49","Z80.9","J93.9","J94.1","R09.1","Z46.82","Z98.890","J95.811","Z48.813","R63.5","Z68.32","D51.1","N92.0","M77.00","M75.22","M62.838","M79.602","L23.2","R21","L29.9","U07.1","G44.1","R06.00","Z20.828","R53.1","R51","Z86.2","Z90.2","Z90.49","D50.0","R10.9","R10.2","R31.21","E78.49","D50.9","K91.1","R31.29","Z12.31","N89.8","Z11.3","N76.0","B00.9","R91.1","H10.9","E55.9","R53.83","D64.9","R30.9","Z23","N39.0","R39.9","Z68.35","R63.4","K95.09","Z68.36","B37.3","E66.01","E28.2","E61.1","R73.9","T73.0XXA","Z86.16","K21.9","Z83.3","Z01.810","J09.X2","E78.00","E53.8","E87.0","L21.9","E05.90","Z01.419","E88.81","D50.8","Z01.818","L40.9","G47.30","G47.33","R73.03","G89.29","Z79.84","D75.839","E66.09","R79.89","F43.21","Z72.821","M25.519","M54.9","R53.82","Z68.34"],"date":["2022-02-25","2020-01-16","2021-11-30","2020-02-26","2020-08-03","2022-02-08","2020-01-29","2022-01-14","2020-01-29","2020-01-29","2020-02-25","2020-02-25","2020-02-25","2022-07-12","2022-02-25","2020-08-03","2021-12-21","2020-02-25","2020-03-03","2020-02-25","2020-02-25","2020-02-28","2021-01-12","2020-02-28","2020-02-28","2022-02-25","2020-03-12","2021-12-21","2022-02-15","2020-05-07","2020-05-10","2020-05-10","2020-05-11","2020-07-21","2020-07-21","2020-07-21","2021-12-26","2022-06-08","2020-07-28","2020-08-15","2020-08-03","2020-08-03","2020-08-03","2020-08-03","2022-07-12","2020-10-25","2020-11-09","2020-11-09","2020-10-25","2021-08-10","2021-11-30","2021-11-11","2020-11-09","2020-11-10","2021-01-04","2021-11-04","2021-01-04","2021-11-04","2021-01-14","2021-04-24","2022-07-12","2021-08-10","2021-08-10","2021-08-10","2021-09-30","2022-07-05","2021-11-04","2022-03-11","2021-11-23","2022-03-11","2022-04-12","2022-07-08","2022-05-10","2022-07-12","2022-07-12","2022-07-12","2021-12-14","2022-04-12","2021-12-21","2021-12-21","2021-12-21","2021-12-22","2022-07-12","2022-07-12","2022-05-10","2022-01-11","2022-01-27","2022-01-27","2022-07-12","2022-02-08","2022-02-08","2022-02-08","2022-02-25","2022-02-25","2022-02-25","2022-02-25","2022-02-25","2022-03-11","2022-07-12","2022-07-12","2022-06-14","2022-06-14","2022-06-08","2022-06-08","2022-06-14","2022-07-12"],"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":[["","70010049110","METFORMIN","TAB 500MG ER","120","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","69315030805","CIPROFLOXACN","SOL 0.3% OP","5","Select","Select",""],["","70710113908","FLUCONAZOLE","TAB 150MG","3","Select","Select",""],["","31722070530","VALACYCLOVIR","TAB 1GM","5","Select","Select",""],["","00555902542","JUNEL","TAB ","21","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","6","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","30","Select","Select",""],["","69097012303","TOPIRAMATE","TAB 50MG","60","Select","Select",""],["","70436001102","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","65862086001","FAMOTIDINE","TAB 40MG","40","Select","Select",""],["","45802049535","DESOXIMETAS","CRE 0.0025","15","Select","Select",""],["","27241009809","DULOXETINE","CAP 30MG","30","Select","Select",""],["","70954018810","ACYCLOVIR","SUS 200\/5ML","100","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","14","Select","Select",""],["","69238126601","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","24208091055","ERYTHROMYCIN","OIN 5MG\/GM","3.5","Select","Select",""],["","24658031205","DOXYCYCL","TAB 100MG","20","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","69097083412","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00378247401","DICLOFEN","TAB 50MG","60","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","08290309571","3ML","MIS 23GX1\"","5","Select","Select",""],["","69680011225","CYANOCOBALAM","INJ 1000MCG","5","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","9","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","30","Select","Select",""],["","57664050658","METOPROL","TAB 25MG","14","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":""}]}]}