{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CYNTHIA STEMEN","gend":1,"add":"8377 JANE LEE CIR","city":"MECHANICSVILLE","state":"VA","zip":"23116-9998","dob":"1962-03-27","age":"","mstatus":"","insh":"20035573*01","cliId":"","pno":"804\/986-9076","cno":"","email":"","ename":"","eno":"","pphy":"HOUGHTON, MICAH MD","ppno":"804\/730-0990","pcpadd":"9376 ATLEE STATION ROAD","pcpcity":"MECHANICSVILLE","pcpstate":"VA","pcpzip":23116,"pcpcounty":"","pcpid":"","pcpname":"VPI - Hanover Family Physicians","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/730-8752","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.5","T14.8XXA","R07.9","S22.31XA","M79.7","F41.9","E66.01","Z68.44","Z23.","F41.1","Z51.81","G43.109","Z98.84","R30.0","R06.02","S29.9XXA","J40.","Z20.822","R05.9","M25.50","I88.9","K13.0","F43.12","M25.561","N39.0","R25.2","J18.9","T21.01XA","T31.0","M25.562","M25.462","R50.9","R09.81","NO DATA","V58.89","R31.9","N30.01","G89.29","S52.502A","W18.30XA","M54.42","G43.009","F32.89","M25.532","S63.512A","G43.119","R00.0","N30.90","Z53.21"],"date":["2020-12-17","2020-03-25","2020-12-17","2020-12-30","2021-10-01","2021-03-25","2020-12-30","2020-12-30","2020-12-30","2020-06-08","2020-06-08","2020-06-08","2020-06-08","2019-09-13","2021-10-01","2020-12-24","2021-10-01","2021-10-01","2021-10-01","2019-11-20","2019-11-20","2019-11-20","2020-03-02","2020-03-04","2019-04-22","2019-05-10","2020-07-11","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2021-10-01","2021-10-01","2021-10-01","2019-02-19","2020-12-17","2020-12-17","2020-12-17","2019-02-08","2019-02-08","2021-03-25","2021-03-25","2021-03-25","2019-02-19","2019-02-19","2019-03-20","2019-08-01","2020-12-17","2020-12-17"],"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":[["","","SUMATRIPTAN"," SUMATRIPTAN ","8","Select","Select",""],["","","DIAZEPAM"," DIAZEPAM ","30","Select","Select",""],["","","TRINTELLIX"," TRINTELLIX ","30","Select","Select",""],["","","TOPIRAMATE"," TOPIRAMATE ","30","Select","Select",""],["","","PROMETHAZINE"," PROMETHAZINE ","30","Select","Select",""],["","","BACLOFEN"," BACLOFEN ","90","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","120","Select","Select",""],["","","CELECOXIB"," CELECOXIB ","30","Select","Select",""],["","","DIPHEN\/ATROP"," DIPHEN\/ATROP ","20","Select","Select",""],["","","OXYCOD\/APAP"," OXYCOD\/APAP ","30","Select","Select",""],["","","ZOLPIDEM"," ZOLPIDEM ","30","Select","Select",""],["","","METHOCARBAM"," METHOCARBAM ","90","Select","Select",""],["","","ALPRAZOLAM"," ALPRAZOLAM ","60","Select","Select",""],["","","ONDANSETRON"," ONDANSETRON ","30","Select","Select",""],["","","GABAPENTIN"," GABAPENTIN ","90","Select","Select",""],["","","LANSOPRAZOLE"," LANSOPRAZOLE ","30","Select","Select",""],["","","TIZANIDINE"," TIZANIDINE ","30","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","30","Select","Select",""],["","","FLUCONAZOLE"," FLUCONAZOLE ","5","Select","Select",""],["","","NARCAN"," NARCAN ","2","Select","Select",""],["","","PROAIR"," PROAIR ","8","Select","Select",""],["","","HYDROMORPHON"," HYDROMORPHON ","12","Select","Select",""],["","","BUSPIRONE"," BUSPIRONE ","90","Select","Select",""],["","","CLOTRIM\/BETA"," CLOTRIM\/BETA ","15","Select","Select",""],["","","AMOXICILLIN"," AMOXICILLIN ","20","Select","Select",""],["","","AJOVY"," AJOVY ","2","Select","Select",""],["","","PREDNISONE"," PREDNISONE ","10","Select","Select",""],["","","MECLIZINE"," MECLIZINE ","40","Select","Select",""],["","","CLONAZEPAM"," CLONAZEPAM ","15","Select","Select",""],["","","MAGNESIUM"," MAGNESIUM ","60","Select","Select",""],["","","EMGALITY","INJ 120MG\/ML","","Select","Select",""],["","","NYSTATIN","SUS 100000","","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","PHENAZOPYRID","TAB 200MG","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","AMOX\/K","TAB 875-125","","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","BENZONATATE","CAP 200MG","","Select","Select",""],["","","PROVENTIL","AER HFA","","Select","Select",""],["","","ESZOPICLONE","TAB 3MG","","Select","Select",""],["","","ONETOUCH","TES ULTRA","","Select","Select",""],["","","METHYLPRED","TAB 4MG","","Select","Select",""],["","","SPIRIVA","CAP HANDIHLR","","Select","Select",""],["","","INCRUSE","INH 62.5MCG","","Select","Select",""],["","","KETOROLAC","TAB 10MG","","Select","Select",""],["","","NEO\/POLY\/HC","SOL 1% OTIC","","Select","Select",""],["","","ACCU-CHEK","TES AVIVA PL","","Select","Select",""],["","","LANCET","MIS THIN 30G","","Select","Select",""],["","","NITROFURANTN","CAP 100MG","","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":""}]}]}