{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DEBORAH   K STEVENS","gend":1,"add":"1084 BOBS HOLE ROAD","city":"TOPPING","state":"VA","zip":"23169-9998","dob":"1953-03-04","age":"","mstatus":"","insh":"900035657*01","cliId":"","pno":"804\/758-5816","cno":"804\/758-5816","email":"","ename":"","eno":"","pphy":"GRISWOLD, STEVEN MD","ppno":"804\/462-5155","pcpadd":"36 LIVELY OAKS ROAD","pcpcity":"LIVELY","pcpstate":"VA","pcpzip":22507,"pcpcounty":"","pcpid":"","pcpname":"BON SECOURS HARTFIELD MEDICAL CENTER","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"CENTRAL","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/462-5922","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N30.01","I25.10","I10.","J44.9","E78.2","Z68.41","F33.3","R53.82","Z86.39","D75.89","K21.0","R49.0","M79.7","M25.511","K43.9","R13.10","R42.","J06.9","R07.81","R06.09","E66.01","R07.9","M54.6","F31.76","A41.9","J18.9","Z20.828","L03.90","R00.0","R09.02","Z87.891","R07.89","J96.01","Z03.818","J90.","D50.0","N39.0","B95.8","F32.9","M81.0","K57.30","Z98.84","Z98.1","Z99.81","Z79.82","R91.8","R93.89","M70.71","M54.41","Z12.31","Z23.","I51.89","R05.","M40.204","K21.9","E11.9","J45.909","Z79.899","R53.83","K92.0","R50.9","J86.9","G47.30","R06.00","M12.811","M79.10","G47.33","R00.2","F32.0","F41.1","F45.42","G31.84","M17.10","R21.","R30.0","F31.32","K56.1","R10.13","I36.1","I27.0","J94.8","J98.11","I25.119","I51.9","E66.9","Z68.39","R06.02","G89.29","H04.123","H40.013","H25.813","H43.813","H35.363","H02.831","H02.834","H18.413","H11.153","H01.02A","H01.02B","Z98.890","L03.114","N64.4","J02.9","I48.0","R35.0","R30.9","R82.90","M54.5","N30.00","Z88.2","Z88.1","Z88.8","Z82.49","R04.89","Z46.82","J98.4","M25.552","M70.62","K90.9","M54.2","M47.812","M54.12","Z45.2","J85.1","Z00.00","H35.369","H52.03","H52.223","R53.1","Z71.9","N18.3","L90.0","B37.3","R68.89","I95.9","R65.21","D62.","N17.9","J44.0","L03.314","J86.0","M25.50","K44.9","M25.512","M51.36","M41.9","M94.0"],"date":["2019-08-20","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2020-12-21","2020-12-14","2019-09-18","2019-09-18","2019-09-18","2020-01-02","2019-12-24","2020-11-11","2020-10-05","2020-01-14","2020-05-04","2020-02-04","2020-02-04","2020-04-08","2020-04-08","2020-10-05","2020-12-21","2020-11-18","2020-04-08","2020-05-04","2020-06-08","2020-12-29","2020-04-23","2020-04-23","2020-05-05","2020-11-11","2020-12-09","2020-06-08","2020-05-06","2020-06-11","2020-06-08","2020-06-08","2020-06-08","2020-06-08","2020-06-08","2020-06-08","2020-12-16","2020-07-22","2020-06-08","2020-11-11","2020-06-11","2020-06-11","2020-07-10","2020-07-22","2020-08-01","2020-11-10","2020-12-09","2020-12-29","2020-02-03","2020-11-11","2020-11-25","2020-11-11","2020-11-11","2020-02-04","2020-04-21","2020-04-21","2020-05-12","2020-05-01","2020-06-10","2020-10-05","2019-08-27","2020-04-21","2019-09-17","2019-10-22","2019-10-22","2019-10-22","2020-01-13","2019-11-05","2019-11-05","2019-09-18","2019-09-18","2020-01-21","2020-01-21","2020-04-30","2020-04-30","2020-05-04","2020-04-30","2020-04-30","2020-04-30","2020-06-11","2020-06-11","2020-06-11","2020-11-18","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-05-04","2020-08-12","2020-09-01","2020-09-18","2019-08-20","2019-09-26","2019-09-26","2019-09-26","2020-04-13","2020-04-21","2020-04-21","2020-04-21","2020-04-21","2020-04-21","2020-05-04","2020-05-05","2020-11-11","2020-12-10","2020-12-10","2020-12-16","2020-04-02","2020-04-02","2020-04-02","2020-05-05","2020-05-15","2020-05-15","2019-10-16","2020-07-28","2020-07-28","2020-02-04","2020-12-09","2019-08-20","2020-01-31","2020-01-31","2020-02-03","2020-02-03","2020-04-21","2020-04-21","2020-04-21","2020-04-21","2020-04-21","2020-05-01","2019-08-27","2020-01-14","2020-07-06","2020-08-05","2020-08-05","2020-11-11"],"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":[]}]},{"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":[["","57237001999","DULOXETINE HYDROCHLORIDE                                              ","60MG","180","Select","Select",""],["","68382018314","BUSPIRONE HCL                                                         ","30MG","60","Select","Select",""],["","00173068220","VENTOLIN HFA                                                          ","","18","Select","Select",""],["","57664050389","TIZANIDINE HYDROCHLORIDE                                              ","4MG","90","Select","Select",""],["","00185067401","HYDROXYZINE PAMOATE                                                   ","25MG","30","Select","Select",""],["","68462039610","OMEPRAZOLE                                                            ","20MG","60","Select","Select",""],["","50111043303","TRAZODONE HYDROCHLORIDE                                               ","50MG","60","Select","Select",""],["","50111078751","AZITHROMYCIN                                                          ","250MG","6","Select","Select",""],["","62332042671","BENZONATATE                                                           ","100MG","21","Select","Select",""],["","69618004610","ASPIRIN ADULT LOW STRENGTH                                            ","81MG EC","30","Select","Select",""],["","00536355101","VITAMIN B-12                                                          ","500MCG","30","Select","Select",""],["","00904323352","CALCIUM\/VITAMIN D                                                     ","600-400","60","Select","Select",""],["","69238131409","PREGABALIN                                                            ","150MG","60","Select","Select",""],["","65162044210","MECLIZINE HYDROCHLORIDE                                               ","25MG","10","Select","Select",""],["","57237000511","FLUCONAZOLE                                                           ","150MG","2","Select","Select",""],["","00469260130","MYRBETRIQ                                                             ","25MG","90","Select","Select",""],["","00378001805","METOPROLOL TARTRATE                                                   ","25MG","180","Select","Select",""],["","51672125901","CLOBETASOL PROPIONATE                                                 ","0.05%","15","Select","Select",""],["","00054001829","PREDNISONE                                                            ","20MG","10","Select","Select",""],["","60505257908","ATORVASTATIN CALCIUM                                                  ","20MG","90","Select","Select",""],["","00591379883","IPRATROPIUM BROMIDE                                                   ","0.02%INH","62","Select","Select",""],["","11017025030","LOTRIMIN AF                                                           ","2%","90","Select","Select",""],["","00487950125","ALBUTEROL SULFATE                                                     ","0.08%","150","Select","Select",""],["","69315011710","FUROSEMIDE                                                            ","40MG","30","Select","Select",""],["","69315090410","LORAZEPAM                                                             ","0.5MG","10","Select","Select",""],["","69315030130","RECTASMOOTHE                                                          ","5%","30","Select","Select",""],["","47781019601","OXYCODONE\/ACETAMINOPHEN                                               ","5-325MG","10","Select","Select",""],["","00054418425","DEXAMETHASONE                                                         ","4MG","14","Select","Select",""],["","40985022309","B-12                                                                  ","500MCG","30","Select","Select",""],["","59762330403","NITROGLYCERIN                                                         ","0.4MG","25","Select","Select",""],["","68180065208","DOXYCYCLINE MONOHYDRATE                                               ","100MG","14","Select","Select",""],["","00143980305","DOXYCYCLINE HYCLATE                                                   ","100MG","20","Select","Select",""],["","00591352530","LIDOCAINE                                                             ","5%","30","Select","Select",""],["","45802005911","NYSTATIN                                                              ","100000","30","Select","Select",""],["","53746010901","HYDROCODONE\/ACETAMINOPHEN                                             ","5-325MG","8","Select","Select",""],["","00093221005","SUCRALFATE                                                            ","1GM","90","Select","Select",""],["","00172409680","BACLOFEN                                                              ","10MG","90","Select","Select",""],["","69097012605","AMLODIPINE BESYLATE                                                   ","2.5MG","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}