{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"WHITLEY   D NETHERLAND","gend":1,"add":"18545 MUDDY CROSS DR","city":"SMITHFIELD","state":"VA","zip":"23430-9998","dob":"1992-12-02","age":"","mstatus":"","insh":"1445575*01","cliId":"","pno":"757\/323-8527","cno":"757\/739-0427","email":"","ename":"","eno":"","pphy":"WILLIAMS, VALENCIA J MD","ppno":"757\/294-3981","pcpadd":"440 COLONIAL TRL W","pcpcity":"DENDRON","pcpstate":"VA","pcpzip":23839,"pcpcounty":"","pcpid":"","pcpname":"HORIZON HEALTH SERVICES INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/294-3985","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","F41.1","F41.9","F41.0","F11.23","F33.2","L03.113","F12.20","G47.00","Z86.69","Z20.822","Z79.899","Z87.442","Z88.6","Z88.1","Z63.4","Z56.0","Z81.4","E86.0","R82.4","R11.2","T40.601A","N15.9","R10.9","E87.6","R40.20","F11.14","F32.9","R56.9","Z72.0","N20.0","N39.0","B96.89","R10.30","T40.1X1A","R00.0","F14.10","F19.10","F12.10","F11.10","R74.8","NO DATA","F15.20","F14.90","T40.1X4A","F15.10","F12.90","T50.991A","F15.90","Z86.59","T50.901A","T50.904A","R09.02","R06.89","T88.7XXA","Z88.5","T65.91XA","R94.31","R40.1","Z74.3","R10.11","K81.2","R11.11","R93.5"],"date":["2022-06-27","2022-05-24","2022-06-26","2022-05-24","2021-06-28","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2022-05-30","2021-06-26","2021-06-26","2022-05-30","2021-06-26","2021-06-26","2021-06-26","2021-06-28","2021-06-28","2021-05-15","2022-04-22","2020-07-30","2020-07-30","2020-07-30","2022-04-23","2021-03-05","2021-03-06","2021-03-06","2021-03-06","2019-03-20","2019-03-20","2019-03-20","2019-03-20","2022-05-31","2022-06-02","2022-04-23","2022-05-30","2022-04-23","2022-04-23","2022-05-31","2022-05-31","2022-05-31","2022-05-31","2022-01-07","2022-01-07","2022-01-07","2022-04-22","2022-01-07","2022-01-07","2022-05-30","2022-04-23","2022-04-23","2022-04-23","2022-04-23","2022-05-30","2022-05-30","2022-06-02","2022-01-07","2022-01-07","2022-11-17","2022-11-17","2022-11-17","2022-11-17"],"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":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","13668000801","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","80681008600","MELATONIN","TAB 3MG","20","Select","Select",""],["","12496120803","SUBOXONE","MIS 8-2MG","3","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","17","Select","Select",""],["","00093321205","CLONAZEPAM","TAB 1MG","120","Select","Select",""],["","62332003131","ROPINIROLE","TAB 0.5MG","30","Select","Select",""],["","00093216568","NALOXONE","SPR ","2","Select","Select",""],["","69097084905","ESCITALOPRAM","TAB 20MG","30","Select","Select",""],["","00904078816","MILK","SUS 1200\/15","473","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","12","Select","Select",""],["","00228212750","CLONIDINE","TAB 0.1MG","1","Select","Select",""],["","69097084615","CYCLOBENZAPR","TAB 10MG","15","Select","Select",""],["","70677005101","MAG","SOL LEMON","296","Select","Select",""],["","00054017613","BUPRENORPHIN","SUB 2MG","1","Select","Select",""],["","00904699446","GAS","CAP 125MG","30","Select","Select",""],["","00093506105","HYDROXYZ","TAB 25MG","10","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","10","Select","Select",""],["","64380080807","IBUPROFEN","TAB 600MG","20","Select","Select",""],["","00378876793","BUPREN\/NALOX","MIS 8-2MG","42","Select","Select",""],["","00832712315","DIVALPROEX","TAB 250MG DR","60","Select","Select",""],["","49483008010","SENNA-TIME","TAB 8.6MG","20","Select","Select",""],["","45802086866","POLYETH","POW 3350 NF","10","Select","Select",""],["","00536124701","SENEXON-S","TAB 8.6-50MG","28","Select","Select",""],["","00093031105","LOPERAMIDE","CAP 2MG","12","Select","Select",""],["","49483034010","ACETAMIN","TAB 325MG","30","Select","Select",""],["","65162062711","TRAMADOL","TAB 50MG","12","Select","Select",""],["","00781185220","AMOX\/K","TAB 875-125","20","Select","Select",""],["","65862001905","CEPHALEXIN","CAP 500MG","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","","ALPRAZOLAM","TAB 2MG","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","68180011302","LEVETIRACETA","TAB 500MG","60","Select","Select",""],["","00406012301","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","69367016304","PHENAZOPYRID","TAB 200MG","6","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":""}]}]}