{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"STEPHANIE  D WILLIAMS","gend":1,"add":"509 WARREN AVE","city":"FRONT ROYAL","state":"VA","zip":22630,"dob":"1987-11-10","age":"","mstatus":"","insh":"20067116*01","cliId":"","pno":"540\/305-1064","cno":"540\/305-1064","email":"","ename":"","eno":"","pphy":"Route,  barbara","ppno":"540\/635-0800","pcpadd":"5424 Discovery Park Blvd BLDB A STE 201","pcpcity":"WILLIAMSBURG","pcpstate":"VA","pcpzip":22630,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"Medicaid","lob":"OHCC","region":"NORTHERN\/ WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/635-0801","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I49.8","E86.1","R78.81","M54.5","I82.210","I82.601","I82.621","N76.4","R11.2","R19.7","K21.9","E78.5","I10.","E66.01","I82.629","Z72.0","Z71.3","G47.33","G47.10","G47.00","R06.83","I82.A23","Z03.89","I87.8","G64.","G90.01","D89.40","I49.9","G90.1","R10.9","NO DATA","Z20.828","J12.9","E21.3","N20.1","N20.0","L30.9","R11.10","J96.01","J18.9","J80.","F39.","E11.65","J45.909","Z79.01","Z79.84","Z79.51","Z79.52","D68.51","R30.0","I82.729","M54.9","M79.631","Z23.","M25.50","R00.0","I95.1","E66.9","N13.30","U07.1","N23.","N13.2","D35.1","E21.0","J45.20","G90.9","R55.","J01.00","Z86.718","N20.2","R31.9","J30.81","J30.1","R09.81","R09.82","Z91.018","R06.02","R53.82","D69.6","K76.0","Z20.822","R94.31","T82.49XA","Q79.60","R10.31","R10.32","G47.30","F51.01","Z01.818","K29.50","R06.89","F17.210","L60.0","B35.1","L03.039","J15.9","Z68.41","Z28.310","F32.9","F41.9","K58.9","N20.9","D68.2","M79.621","T82.868A","I82.A11","I82.611","Z11.59","Z68.38","G89.4","R10.30","R74.8","J96.00","E11.9","M79.661","R50.9","B96.81","Z01.810","Z09.","Z45.2","I65.23","G43.101","G43.019","H11.31","R53.83","E89.2","E66.3","Z68.37","Q24.9","R00.2","R07.9","R11.0","R20.0","R20.2","R42.","M79.601","R74.01","R93.1","R51.9","I51.89","R41.82","R40.20","H57.11","F48.8","G89.29","Z79.899","R06.9","R09.02","E78.00","E83.52","H66.91","J20.9","D68.59","F33.0","R06.03","R53.81","M62.81","R26.2","M54.2","M24.80"],"date":["2022-09-16","2022-09-16","2020-07-15","2021-03-29","2020-07-15","2020-07-15","2020-07-28","2020-07-15","2021-04-06","2021-01-07","2022-09-19","2022-09-19","2022-09-19","2022-08-30","2020-07-29","2020-07-29","2020-07-29","2020-10-16","2020-10-16","2021-01-31","2020-10-16","2022-09-19","2020-10-29","2020-11-12","2020-11-12","2020-11-12","2022-08-30","2020-11-12","2020-11-12","2022-08-29","2022-10-25","2020-12-16","2021-01-31","2021-04-22","2021-06-26","2022-09-30","2021-09-13","2022-09-16","2022-09-19","2022-09-16","2022-09-11","2022-09-16","2022-09-19","2022-09-19","2022-09-19","2022-09-19","2022-09-19","2022-09-19","2022-08-30","2020-06-25","2020-07-13","2021-07-04","2020-09-04","2020-09-04","2022-10-25","2020-09-04","2022-03-18","2020-11-23","2021-04-07","2021-04-06","2021-04-06","2021-04-06","2021-04-22","2022-09-30","2021-04-30","2021-05-26","2021-06-19","2021-06-19","2021-06-19","2021-06-26","2021-07-05","2022-08-15","2022-08-15","2022-08-15","2022-08-15","2022-08-15","2022-08-29","2022-08-15","2022-08-29","2022-08-29","2022-08-29","2022-09-13","2021-01-07","2022-08-30","2020-06-22","2020-06-22","2020-08-10","2020-08-25","2021-01-21","2020-12-03","2022-08-29","2021-03-26","2021-10-12","2021-10-12","2021-10-12","2022-08-30","2022-08-30","2022-08-29","2022-08-29","2022-08-29","2022-08-29","2020-09-24","2020-07-12","2020-07-13","2020-07-11","2020-07-17","2020-07-17","2020-07-11","2020-07-11","2020-07-11","2021-01-29","2021-01-29","2022-08-30","2022-09-11","2022-09-20","2022-08-29","2020-12-03","2021-01-21","2021-02-12","2021-03-05","2021-03-09","2021-03-09","2021-09-02","2021-09-02","2022-08-17","2022-09-30","2020-08-10","2020-08-10","2020-08-24","2022-03-18","2022-03-18","2022-08-26","2020-08-25","2020-08-25","2022-08-26","2020-09-04","2020-10-27","2020-12-04","2020-12-27","2021-05-24","2021-06-18","2021-06-18","2021-09-02","2020-11-12","2021-01-07","2021-02-10","2022-08-29","2022-08-29","2020-06-21","2022-09-30","2021-06-15","2021-06-15","2022-08-30","2022-08-30","2022-08-30","2022-10-20","2022-10-20","2022-10-20","2022-10-20","2022-10-25"],"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":[["","65862064860","RIVASTIGMINE","CAP 1.5MG","60","Select","Select",""],["","50458057930","XARELTO","TAB 20MG","30","Select","Select",""],["","68001015403","CARVEDILOL","TAB 6.25MG","90","Select","Select",""],["","00228212750","CLONIDINE","TAB 0.1MG","180","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","180","Select","Select",""],["","54629007501","MULTI-VIT\/","TAB MINERALS","30","Select","Select",""],["","13668008190","MONTELUKAST","TAB 10MG","180","Select","Select",""],["","00781223401","OMEPRAZOLE","CAP 40MG","56","Select","Select",""],["","68180051202","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","43547028110","ESCITALOPRAM","TAB 10MG","45","Select","Select",""],["","68682030210","PYRIDOSTIGM","TAB 60MG","720","Select","Select",""],["","69097084615","CYCLOBENZAPR","TAB 10MG","90","Select","Select",""],["","23155050201","HYDROXYZ","TAB 50MG","540","Select","Select",""],["","13107003234","MIRTAZAPINE","TAB 45MG","90","Select","Select",""],["","00245021211","MIDODRINE","TAB 5MG","360","Select","Select",""],["","67877019805","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","00085461001","DULERA","AER 200-5MCG","13","Select","Select",""],["","50111043302","TRAZODONE","TAB 50MG","30","Select","Select",""],["","68180067711","OSELTAMIVIR","CAP 75MG","10","Select","Select",""],["","00168000315","TRIAMCINOLON","CRE 0.00025","30","Select","Select",""],["","27241011603","FENOFIBRATE","TAB 54MG","30","Select","Select",""],["","69315011710","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","69097031987","BUDESONIDE","SUS 0.5MG\/2","120","Select","Select",""],["","68180065208","DOXYCYC","CAP 100MG","28","Select","Select",""],["","67877024901","QUETIAPINE","TAB 50MG","60","Select","Select",""],["","31722071310","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","70010006310","METFORMIN","TAB 500MG","60","Select","Select",""],["","53885027210","ONETOUCH","TES VERIO","100","Select","Select",""],["","45802086802","POLYETH","POW 3350 NF","476","Select","Select",""],["","45802058046","SCOPOLAMINE","DIS 1MG\/3DAY","10","Select","Select",""],["","80681006300","TAB-A-VITE","TAB IRON\/BET","30","Select","Select",""],["","56151146004","TRUE","TES GLUCOSE","100","Select","Select",""],["","65702071210","ACCU-CHEK","TES GUIDE","100","Select","Select",""],["","00378064210","PREDNISONE","TAB 20MG","6","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","10","Select","Select",""],["","96295013675","VITAMIN","TAB 500MCG","90","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","100","Select","Select",""],["","50228043601","NAPROXEN","TAB 500MG","20","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","30","Select","Select",""],["","00310737020","BUDES\/FORMOT","AER 160-4.5","10","Select","Select",""],["","27808003501","HYDROCO\/APAP","TAB 5-325MG","20","Select","Select",""],["","67877021905","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","67386082019","NORTHERA","CAP 100MG","90","Select","Select",""],["","70000034501","NICOTINE","GUM 2MG ORIG","240","Select","Select",""],["","10702001801","OXYCODONE","TAB 5MG","20","Select","Select",""],["","67877022205","GABAPENTIN","CAP 100MG","150","Select","Select",""],["","26608000150","BIO"," ","7","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","14","Select","Select",""],["","00115165903","PROPRANOLOL","TAB 10MG","90","Select","Select",""],["","14832001101","NASALCROM","SPR 5.2\/ACT","26","Select","Select",""],["","16571060096","CROMOLYN","CON 100\/5ML","1440","Select","Select",""],["","57664037713","TRAMADOL","TAB 50MG","20","Select","Select",""],["","00904641292","CALC","CHW 500MG","60","Select","Select",""],["","00904699860","DOCUSATE","CAP 100MG","28","Select","Select",""],["","00186037020","SYMBICORT","AER 160-4.5","10","Select","Select",""],["","75826011510","PHENAZOPYRID","TAB 200MG","20","Select","Select",""],["","00904645760","DOK","CAP 100MG","28","Select","Select",""],["","42571016242","AMOX\/K","TAB 875-125","14","Select","Select",""],["","00406048401","APAP\/CODEINE","TAB 300-30MG","20","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","20","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","56","Select","Select",""],["","55513080060","CORLANOR","TAB 5MG","60","Select","Select",""],["","47781019601","OXYCOD\/APAP","TAB 5-325MG","10","Select","Select",""],["","00781196260","CLARITHROMYC","TAB 500MG","28","Select","Select",""],["","00591079401","DICYCLOMINE","CAP 10MG","120","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":""}]}]}