{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"LINDA   J OWEN","gend":1,"add":"16679 KITES DR","city":"ELKTON","state":"VA","zip":"22827-9998","dob":"1956-07-23","age":"","mstatus":"","insh":"20056642*01","cliId":"","pno":"540\/810-1380","cno":"540\/810-1380","email":"","ename":"","eno":"","pphy":"LONG, KEITH C MD","ppno":"540\/298-1200","pcpadd":"13737 SPOTSWOOD TRL","pcpcity":"ELKTON","pcpstate":"VA","pcpzip":22827,"pcpcounty":"","pcpid":"","pcpname":"SRMHMG - Sentara East Rockingham Health Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/579-8587","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.9","R39.81","R39.9","R13.10","R41.3","I10.","E03.9","E11.8","E11.65","M54.42","M43.06","M41.9","E66.01","F33.9","Z79.4","M54.41","Z68.41","N32.81","N39.41","NO DATA","R51.9","M54.81","M25.512","R07.9","R35.0","F33.41","F41.1","F06.30","G47.30","F39.","E78.2","G89.29","M62.81","M16.12","M51.36","S30.0XXA","Z23.","N64.4","R39.15","E10.9","V58.89","M75.42","M19.012","Z98.890","G47.33","G47.61","G47.10","R06.83","R35.1","M79.7","Z91.19","Z86.718","Z86.73","Z88.1","Z88.2","Z88.8","Z99.81","M17.12","N62.","M54.2","M54.9","M25.511","H34.231","M25.551","Z96.651","M25.561","M70.61","M25.552","M25.562","M70.62","J31.0","H60.92","R41.89","F45.9","Z12.4","Z00.00","R09.81","D22.9","I83.93","K21.0","S46.012A","G89.18","G47.19","Z20.828","Z91.14","R13.12","M54.5","J01.90","R47.89","F51.13","M75.122","M75.22","S43.432A","R53.81","F32.89","R53.83","B00.9","Z01.812","Z20.822","H25.13","Z91.81","N30.00","R51.","J30.9","R49.0","J38.7","M79.18","M31.6","H53.8","Z01.818"],"date":["2022-10-24","2022-01-27","2021-02-08","2021-03-17","2022-01-28","2022-07-21","2022-07-21","2022-07-21","2022-01-04","2022-06-03","2021-08-31","2021-08-31","2022-01-04","2022-07-21","2022-07-21","2022-06-03","2022-01-04","2022-10-24","2022-10-24","2022-08-15","2022-08-15","2022-08-15","2022-06-03","2020-09-16","2021-01-22","2021-07-13","2021-07-13","2021-07-13","2021-07-13","2021-07-13","2021-07-28","2022-06-03","2021-12-01","2021-12-01","2021-12-13","2021-10-18","2021-11-04","2022-04-27","2020-09-24","2021-09-27","2021-04-07","2021-04-07","2021-04-07","2021-04-07","2022-04-25","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-02-24","2021-12-13","2022-06-03","2022-06-03","2022-06-03","2022-06-03","2020-01-27","2020-03-17","2020-03-17","2020-03-17","2020-03-17","2020-03-17","2020-03-17","2020-03-17","2020-07-10","2020-07-10","2021-04-27","2021-07-13","2022-03-22","2020-06-16","2022-01-12","2020-06-16","2020-06-16","2020-06-16","2020-11-11","2020-11-11","2020-12-23","2020-12-23","2020-12-23","2021-05-11","2021-09-29","2022-01-12","2022-05-31","2020-07-22","2020-11-11","2020-11-11","2020-11-11","2020-12-22","2020-12-22","2020-12-22","2022-07-21","2021-02-22","2021-02-22","2021-09-27","2022-01-04","2022-09-02","2020-06-30","2020-06-30","2020-06-30","2020-06-30","2021-06-11","2022-07-20","2022-07-20","2022-07-20"],"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":[]},{"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":[["","04142000024","FLORASTOR","CAP 250MG","30","Select","Select",""],["","57896086905","PROBIOTIC","CAP 250MG","30","Select","Select",""],["","65862024608","LEVETIRACETA","TAB 500MG","60","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","72205002790","ROSUVASTATIN","TAB 5MG","90","Select","Select",""],["","10702020101","OXYBUTYNIN","TAB 5MG","90","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","68001033508","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","65162047810","NITROFURANTN","CAP 100MG","14","Select","Select",""],["","31722077801","ACYCLOVIR","TAB 800MG","30","Select","Select",""],["","75834050005","METFORMIN","TAB 500MG ER","90","Select","Select",""],["","24208041005","OFLOXACIN","DRO 0.3%OTIC","5","Select","Select",""],["","68645052354","SERTRALINE","TAB 100MG","180","Select","Select",""],["","00781518092","LEVOTHYROXIN","TAB 25MCG","90","Select","Select",""],["","67877019805","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00169406012","VICTOZA","INJ 18MG\/3ML","9","Select","Select",""],["","68645055654","LISINOP\/HCTZ","TAB 10-12.5","90","Select","Select",""],["","57599000101","FREESTYLE    KIT SENSOR","KIT SENSOR","6","Select","Select",""],["","16714065204","CIPROFLOXACN","TAB 500MG","14","Select","Select",""],["","00169255013","TRESIBA","INJ 200UNIT","9","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","72305002530","EUTHYROX","TAB 25MCG","90","Select","Select",""],["","13668019090","TOLTERODINE","CAP 4MG ER","90","Select","Select",""],["","68645014059","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","49035065078","ACID","TAB 20MG","60","Select","Select",""],["","68462018022","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","00469260130","MYRBETRIQ","TAB 25MG","30","Select","Select",""],["","13107001401","GLYCOPYRROL","TAB 1MG","60","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","49281042050","FLUZONE","INJ 2020-21","0","Select","Select",""],["","42858010250","OXYCOD\/APAP","TAB 5-325MG","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":["",""],"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":""}]}]}