{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"BOBBIE   J SANDERS","gend":1,"add":"122 AUTUMN LANE","city":"SHENANDOAH","state":"VA","zip":"22849-4131","dob":"1977-05-04","age":"","mstatus":"","insh":4318876,"cliId":"","pno":5403250957,"cno":5403250957,"email":"","ename":"","eno":"","pphy":"SWITZER, DAVID S","ppno":5407432887,"pcpadd":"250 Memorial Dr, ","pcpcity":"Luray","pcpstate":"VA","pcpzip":228351000,"pcpcounty":"","pcpid":"","pcpname":"","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":5409752103,"add2":"                                                            ","add3":"","madd1":"122 AUTUMN LANE","madd2":"                                                            ","madd3":"","mcity":"SHENANDOAH","mstate":"VA","mzip":"22849-4131","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N39.3","L28.0","Z68.29","R10.2","R10.9","R93.5","Z86.73","M79.7","I10","Z79.899","Z88.5","Z88.8","J45.909","F41.9","F32.9","N88.2","N89.7","N73.0","N83.201","Z87.42","F33.1","R05","R07.89","R07.81","M79.10","M77.12","M70.62","M75.112","M54.5","M54.17","M51.37","M51.17","D06.9","N39.42","M79.651","R10.31","Z12.31","N95.1","R23.2","R07.9","R92.8","S09.90XA","M47.817","M25.512","G89.29","M47.897","M48.07","M75.102","R93.7","M89.9","M25.412","H90.5","R22.0","M51.36","M51.16","Z01.818","M53.3","J40","M25.551","M54.9","G47.00","Z87.442","N85.8","M25.511","B49","B36.9","H62.40","M79.605","M79.604","Z88.6","N28.1","Z12.4","Z01.419","N89.8","F33.9","E07.9","M19.90","Z82.49","Z82.3","Z47.89","Z98.1","N87.1","F41.1","L03.119","L23.7","M25.522","M25.552","R51","M75.82","K21.9","Z80.1","Z80.6","Z80.0","L02.01","N39.46","Z01.812","F41.0","N95.2","N60.11","M85.40","Z98.890","E28.39","L90.0","R09.81","R06.2","J34.89","N72","N90.4","E66.3","R06.02","Z80.8","M47.816","M54.41","N85.7","R29.6","L03.114","L81.8","G89.18","N88.8","Z09","N64.4","Z23","M43.27"],"date":["2019-10-07","2020-05-13","2019-04-18","2021-03-29","2021-03-31","2019-06-20","2019-06-20","2019-06-20","2019-06-20","2020-12-04","2021-03-31","2021-03-31","2021-03-31","2021-03-31","2019-06-20","2019-06-21","2019-06-21","2019-06-27","2019-08-07","2019-08-07","2020-01-15","2021-04-09","2020-05-17","2020-01-15","2020-04-24","2020-09-24","2020-09-24","2020-12-04","2020-11-09","2021-01-20","2021-01-20","2021-03-31","2019-01-03","2019-09-19","2019-05-10","2019-05-10","2021-03-01","2021-03-29","2019-08-29","2020-05-20","2020-05-28","2020-09-09","2020-10-21","2020-12-04","2021-03-31","2020-10-21","2020-10-21","2020-10-21","2020-10-21","2020-10-21","2020-10-21","2020-10-26","2021-02-04","2021-03-31","2021-05-11","2021-03-29","2020-09-09","2019-02-19","2019-05-10","2019-05-10","2019-05-10","2020-12-04","2019-06-20","2020-01-09","2020-09-23","2020-09-23","2020-09-23","2020-11-09","2020-11-09","2021-03-31","2020-11-10","2021-03-01","2021-03-01","2021-03-01","2021-03-31","2021-03-31","2021-03-31","2021-03-31","2021-03-31","2021-05-11","2021-05-11","2019-01-03","2019-07-29","2019-07-29","2020-03-11","2020-09-09","2020-09-09","2020-09-09","2020-12-04","2021-01-14","2020-12-04","2020-12-04","2020-12-04","2021-01-14","2019-03-08","2019-09-19","2020-01-18","2020-05-13","2020-05-28","2020-09-09","2021-01-21","2021-03-29","2021-03-29","2021-04-09","2021-04-09","2021-04-09","2019-01-03","2019-05-15","2019-05-15","2020-01-18","2020-05-19","2020-10-21","2019-03-26","2019-06-21","2020-09-09","2020-10-02","2020-10-02","2020-12-04","2021-03-18","2019-11-07","2020-05-17","2020-11-09","2021-05-11"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"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":[]}]},{"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":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","27241009990","DULOXETINE ","CAP 60MG","60","Select","Select",""],["","68180096301","ALBUTEROL ","AER HFA","8.5","Select","Select",""],["","45802065087","LORATADINE ","TAB 10MG","30","Select","Select",""],["","59762005801","MEDROXYPR ","TAB 5MG","30","Select","Select",""],["","69097095605","PREGABALIN ","CAP 75MG","90","Select","Select",""],["","68462039610","OMEPRAZOLE ","CAP 20MG","30","Select","Select",""],["","00071101468","LYRICA ","CAP 75MG","90","Select","Select",""],["","67253090150","ALPRAZOLAM ","TAB 0.5MG","30","Select","Select",""],["","68001032205","BUPROPN ","TAB 150MG XL","30","Select","Select",""],["","64380080308","RANITIDINE ","TAB 150MG","60","Select","Select",""],["","00378464326","ESTRADIOL ","DIS 0.0375MG","8","Select","Select",""],["","65862001905","CEPHALEXIN ","CAP 500MG","30","Select","Select",""],["","29300016815","TIZANIDINE ","TAB 2MG","30","Select","Select",""],["","59746017310","PREDNISONE ","TAB 10MG","23","Select","Select",""],["","69097096507","NABUMETONE ","TAB 500MG","42","Select","Select",""],["","00406055201","OXYCODONE ","TAB 5MG","21","Select","Select",""],["","69547035302","NARCAN ","SPR ","2","Select","Select",""],["","00046087221","PREMARIN ","CRE 0.625MG","30","Select","Select",""],["","69097014807","LAMOTRIGINE ","TAB 25MG","30","Select","Select",""],["","00378034501","DIAZEPAM ","TAB 5MG","2","Select","Select",""],["","68001024617","ONDANSETRON ","TAB 4MG ODT","21","Select","Select",""],["","59310057922","PROAIR ","AER ","8.5","Select","Select",""],["","65162019011","NAPROXEN ","TAB 500MG","20","Select","Select",""],["","00781261305","AMOXICILLIN ","CAP 500MG","21","Select","Select",""],["","68001036503","METRONIDAZOL ","TAB 500MG","28","Select","Select",""],["","67877032005","IBUPROFEN ","TAB 600MG","20","Select","Select",""],["","00116200116","CHLORHEX ","SOL 0.0012","473","Select","Select",""],["","69452014430","BENZONATATE ","CAP 200MG","30","Select","Select",""],["","51672125801","CLOBETASOL ","CRE 0.0005","15","Select","Select",""],["","65862050320","AMOX\/K ","TAB 875-125","20","Select","Select",""],["","42806031205","DOXYCYCL ","TAB 100MG","28","Select","Select",""],["","45802086801","POLYETH ","POW 3350 NF","119","Select","Select",""],["","65862042005","SMZ\/TMP ","TAB 800-160","28","Select","Select",""],["","00781196260","CLARITHROMYC ","TAB 500MG","28","Select","Select",""],["","16729017217","AMITRIPTYLIN ","TAB 25MG","30","Select","Select",""],["","51224002230","AZITHROMYCIN ","TAB 250MG","6","Select","Select",""],["","68001025204","FLUCONAZOLE ","TAB 100MG","7","Select","Select",""],["","63304069201","CLINDAMYCIN ","CAP 150MG","30","Select","Select",""]]}},{"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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[[["No","Select","","","","","Select","",""],["No","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["N\/A","Select","","","","","Select","",""],["Yes","Select","","","","","Select","",""]]]},{"t":"Mini-Cog","q":[{"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":""}]}]}