{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"REGINA   R RICKARD","gend":1,"add":"56 MARIGOLD LN","city":"LURAY","state":"VA","zip":"22835-9998","dob":"1971-06-19","age":"","mstatus":"","insh":"900035957*01","cliId":"","pno":"540\/860-0368","cno":"","email":"","ename":"","eno":"","pphy":"ARSHI, MANPREET MD","ppno":"540\/743-2887","pcpadd":"135 MEMORIAL DRIVE","pcpcity":"LURAY","pcpstate":"VA","pcpzip":22835,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICARE","lob":"DSNP","region":"NORTHERN & WINCHESTER","aligned":"Y","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/743-1288","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F43.10","L20.89","L91.8","R20.8","D22.5","D22.4","M25.50","R19.7","R50.9","R93.3","K57.30","M79.642","M79.641","E78.2","I10.","M19.90","K57.92","R10.32","E78.5","Z09.","R10.9","H25.13","Z00.00","E55.9","Z12.31","K57.32","R06.2","H35.52","K21.9","K57.33","R10.30","H25.043","H25.11","H25.041","H25.812","E78.00","Z98.41","Z96.1","Z88.5","Z91.040","Z88.0","Z88.2","Z79.899","Z87.891","F41.9","F34.1","F40.01","F33.41","F43.12","F32.9","L30.9","J01.10","J40.","R93.7","B37.3","F41.1","F33.42","F51.01","R11.0","R51.","G47.9","E78.49","R07.9","J45.21","R00.2","J45.41","J45.901","R49.0","K63.5","E66.9","J45.909","H25.12","J45.20","J30.2","Z12.39","M79.604","M25.572","M79.605","R07.89","F99.","Z91.09","E78.70","M79.661","M79.662","R22.30","Z01.411","B37.2","N95.1","I49.3"],"date":["2021-10-25","2020-07-10","2020-07-10","2020-07-10","2020-07-10","2020-07-10","2020-08-07","2020-08-07","2020-08-07","2020-10-26","2021-04-07","2020-12-31","2020-12-31","2021-08-06","2021-08-31","2020-12-31","2021-04-08","2021-03-11","2021-03-11","2021-04-07","2021-04-08","2021-07-27","2020-03-11","2021-08-06","2021-10-14","2021-03-11","2020-08-07","2021-08-31","2020-10-27","2021-03-11","2021-03-11","2021-05-20","2021-07-13","2021-05-20","2021-08-31","2021-08-31","2021-08-31","2021-08-31","2021-08-31","2021-08-31","2021-08-31","2021-08-31","2021-08-31","2021-08-31","2020-12-30","2020-12-30","2021-01-06","2019-09-04","2021-03-24","2020-12-30","2020-03-16","2019-12-31","2019-12-31","2020-02-03","2020-04-20","2020-12-30","2021-03-24","2020-12-30","2020-07-20","2020-07-20","2020-07-20","2020-07-20","2020-09-01","2019-10-31","2019-10-31","2019-12-09","2019-12-17","2019-12-17","2020-06-16","2020-07-31","2020-10-26","2021-08-31","2019-11-14","2020-03-16","2020-03-02","2020-03-16","2020-03-16","2020-03-16","2020-07-13","2021-03-24","2021-07-13","2021-07-13","2020-03-04","2020-03-04","2020-02-03","2021-10-05","2021-10-05","2021-10-05","2020-09-01"],"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":[["","00093083205","CLONAZEPAM                                                            ","0.5MG","60","Select","Select",""],["","70377002811","ATORVASTATIN CALCIUM                                                  ","20MG","90","Select","Select",""],["","00186037220","SYMBICORT                                                             ","80-4.5","10","Select","Select",""],["","50111043301","TRAZODONE HYDROCHLORIDE                                               ","50MG","30","Select","Select",""],["","68382002210","ATENOLOL                                                              ","25MG","90","Select","Select",""],["","13668001105","CITALOPRAM HYDROBROMIDE                                               ","40MG","90","Select","Select",""],["","50111033401","METRONIDAZOLE                                                         ","500MG","30","Select","Select",""],["","65862007701","CIPROFLOXACIN HYDROCHLORIDE                                           ","500MG","20","Select","Select",""],["","70710113908","FLUCONAZOLE                                                           ","150MG","2","Select","Select",""],["","00168000615","TRIAMCINOLONE ACETONIDE                                               ","0.10%","60","Select","Select",""],["","65862039110","ONDANSETRON ODT                                                       ","8MG ODT","20","Select","Select",""],["","00143312601","DICYCLOMINE HYDROCHLORIDE                                             ","10MG","30","Select","Select",""],["","60758011910","PREDNISOLONE ACETATE                                                  ","1% OP","10","Select","Select",""],["","51672128902","NYSTATIN                                                              ","100000","30","Select","Select",""],["","19515081852","FLULAVAL QUADRIVALENT 2021-2022                                       ","2021-22","0","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":""}]}]}