{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RUTH  A HESS","gend":1,"add":"980 CLEARVIEW DR LOT 7","city":"HONAKER","state":"VA","zip":24260,"dob":"1975-04-25","age":"","mstatus":"","insh":"20029104*01","cliId":"","pno":"276\/329-5623","cno":"","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"276\/873-6300","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":24260,"pcpcounty":"","pcpid":"","pcpname":"COMMUNITY HEALTH CLINIC PC","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"276\/873-5859","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L98.492","M13.112","J44.9","Z87.440","Z45.2","Z48.01","L97.319","L03.115","E11.9","I10.","G25.81","Z79.2","L08.9","R06.00","R06.4","R21.","R45.82","Z74.3","F33.3","F41.1","G47.00","F15.90","L03.90","F41.9","M86.071","S91.301A","T84.624A","M86.171","R27.0","M25.571","M86.061","B95.2","B96.89","Z47.89","K21.9","M25.579","F31.9","Z87.39","F19.951","R44.3","F22.","F19.10","T50.902A","T14.91XA","D72.829","T81.89XA","F17.200","R00.2","F32.9","F17.210","E83.39","A49.01","V54.16","Z79.82","Z79.899","Z88.5","M86.9","L97.512","A41.9","E87.6","T43.622A","R00.0","H93.13","Z13.6","F15.10","T84.7XXA","S91.001A","Z00.01","Z04.89","F33.2","F15.20","F33.9","R10.31","N39.0","N30.00","F99.","R45.7","M86.671","F15.959","R07.89","Z11.52","T88.7XXA","R07.9","M79.672","K76.0","R16.0","Z90.49","Z86.14","NO DATA","Z88.6","Z79.84","R10.9","M00.071","B95.62","M15.9","M79.7","L98.499","D50.9","M79.671","R44.1","M86.172","Z20.822","M19.90","T84.59XA","M00.9","G62.9","E86.0","F34.1","F41.8","Z86.19","F12.90","H54.7","V62.84","E06.9","E04.1","M79.604","L03.113","L03.114","Z00.8","Z13.9","Z13.89","R60.0","M25.512","L98.9","L02.414","L02.413","L02.01","R31.9","R53.1","J20.9","R78.81","E87.2","M65.231","F39.","M75.52","M13.812","G89.29","M67.88","R06.02","R50.9","U07.1","J01.90","J06.9","R05.9","M25.471","Z01.810","T81.49XA","R22.41","J18.9","M51.37","M79.2","M00.871","T84.69XA","D64.9"],"date":["2020-02-05","2020-02-05","2022-01-17","2020-02-05","2021-08-23","2020-02-05","2020-04-07","2022-07-29","2021-10-25","2022-09-06","2022-07-19","2021-08-11","2021-07-10","2021-10-04","2020-07-09","2020-07-09","2020-07-09","2021-07-10","2020-08-31","2020-08-31","2020-08-31","2020-08-31","2020-08-31","2022-01-17","2021-07-13","2021-07-10","2021-07-13","2022-09-06","2021-08-11","2022-07-26","2021-08-23","2021-08-23","2021-08-23","2021-08-23","2022-09-06","2022-05-17","2021-08-25","2021-12-15","2020-08-26","2020-08-26","2020-08-26","2020-08-26","2021-05-24","2021-05-22","2021-05-23","2021-05-24","2021-05-24","2021-07-13","2021-07-10","2022-01-17","2021-07-10","2021-07-10","2021-07-15","2021-07-10","2022-01-17","2022-01-17","2022-01-17","2021-07-16","2020-07-09","2020-07-09","2021-05-22","2021-05-22","2021-05-22","2021-05-24","2021-07-10","2021-07-13","2021-07-13","2020-04-15","2020-04-15","2021-05-28","2021-05-28","2022-09-06","2021-10-25","2021-10-25","2021-11-13","2020-04-15","2020-04-15","2022-07-27","2020-08-26","2021-02-08","2021-02-08","2021-02-08","2022-01-17","2021-10-18","2021-10-25","2021-10-25","2021-10-25","2021-10-25","2022-01-17","2021-10-25","2021-10-25","2021-10-25","2020-02-22","2020-02-22","2020-02-22","2022-01-17","2020-02-22","2020-02-22","2022-07-19","2020-08-26","2022-04-25","2022-07-26","2021-07-16","2020-07-09","2020-07-09","2020-07-09","2020-07-09","2020-07-09","2020-07-09","2020-07-09","2021-05-22","2021-05-22","2021-05-22","2021-09-15","2021-09-15","2021-11-30","2019-08-22","2019-08-22","2019-08-22","2019-08-22","2019-08-22","2019-08-22","2019-12-14","2019-08-15","2019-08-15","2019-08-15","2019-08-15","2019-12-17","2019-12-17","2022-01-28","2019-12-17","2019-12-17","2019-12-17","2022-02-24","2019-12-17","2019-12-17","2019-12-17","2019-12-17","2022-01-17","2022-01-17","2022-01-17","2022-01-14","2022-01-17","2022-01-17","2022-07-26","2022-07-27","2022-07-26","2022-07-26","2022-01-28","2022-05-17","2022-05-17","2022-07-27","2022-07-26","2022-07-26"],"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":[["","55111065990","ROPINIROLE","TAB 2MG ER","30","Select","Select",""],["","00143314205","DOXYCYCL","CAP 100MG","20","Select","Select",""],["","63824000815","MUCINEX","TAB 600MG ER","20","Select","Select",""],["","42192060716","BROM\/PSE\/DM","SYP 2\/30\/10","180","Select","Select",""],["","29300012410","MELOXICAM","TAB 7.5MG","30","Select","Select",""],["","69452014320","BENZONATATE","CAP 100MG","15","Select","Select",""],["","00093031401","KETOROLAC","TAB 10MG","20","Select","Select",""],["","62756018388","OXCARBAZEPIN","TAB 150MG","60","Select","Select",""],["","69367020305","BUT\/APAP\/CAF","TAB ","60","Select","Select",""],["","69097014807","LAMOTRIGINE","TAB 25MG","30","Select","Select",""],["","64980016905","HYDROXYZ","CAP 25MG","60","Select","Select",""],["","69097012815","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","65862019405","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","68382018201","BUSPIRONE","TAB 15MG","90","Select","Select",""],["","49483060610","GABAPENTIN","CAP 300MG","30","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","43598021085","SSD","CRE 0.01","85","Select","Select",""],["","59762501002","CLINDAMYCIN","CAP 300MG","84","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","14","Select","Select",""],["","67877024201","QUETIAPINE","TAB 25MG","30","Select","Select",""],["","68462018022","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","70594004801","VANCOMYCIN","INJ 10GM","2","Select","Select",""],["","","SERTRALINE","TAB 50MG","","Select","Select",""],["","","HEPARIN","INJ 10UNT\/ML","","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","30","Select","Select",""],["","00115681110","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","57237020599","LOSARTAN","TAB 50MG","30","Select","Select",""],["","55111064505","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","08327030909","SILVASORB","GEL ","44","Select","Select",""],["","","HYDROCO\/APAP","TAB 7.5-325","","Select","Select",""],["","67877041984","LINEZOLID","TAB 600MG","30","Select","Select",""],["","08290093010","NORMAL","INJ 0.009","450","Select","Select",""],["","51672403903","ENALAPRIL","TAB 10MG","30","Select","Select",""],["","16729017117","AMITRIPTYLIN","TAB 10MG","30","Select","Select",""],["","00228255011","DICLOFENAC","TAB 50MG DR","60","Select","Select",""],["","","DAPTOMYCIN","INJ 500MG","","Select","Select",""],["","57237010001","METOPROL","TAB 25MG","60","Select","Select",""],["","","ZINC","CAP 220MG","","Select","Select",""],["","","PANTOPRAZOLE","TAB 40MG","","Select","Select",""],["","","BUPROPION","TAB 150MG SR","","Select","Select",""],["","","RISPERIDONE","TAB 1MG","","Select","Select",""],["","","PRAZOSIN","CAP 1MG","","Select","Select",""],["","","LISINOPRIL","TAB 5MG","","Select","Select",""],["","","IBU","TAB 400MG","","Select","Select",""],["","65862000705","CITALOPRAM","TAB 40MG","30","Select","Select",""],["","00591544310","PREDNISONE","TAB 20MG","10","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","59310057922","PROAIR","AER ","8","Select","Select",""],["","00409733201","CEFTRIAXONE","INJ 1GM","28","Select","Select",""],["","00603158658","PROMETHAZINE","SYP DM","118","Select","Select",""],["","67877012485","SILVER","CRE 0.01","80","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}