{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RICHARD   D WOLFORD","gend":0,"add":"11304 SETZER ROAD","city":"STONY CREEK","state":"VA","zip":"23882-9998","dob":"1961-06-27","age":"","mstatus":"","insh":"20069178*01","cliId":"","pno":"434\/246-6012","cno":"434\/246-6012","email":"","ename":"","eno":"","pphy":"MATHERLEE, MICHAEL D MD","ppno":"434\/246-6100","pcpadd":"12454 HARTLEY ST","pcpcity":"STONY CREEK","pcpstate":"VA","pcpzip":23882,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"434\/246-6614","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S27.0XXA","S22.41XA","J96.00","R57.8","S22.009A","W11.XXXA","S22.089A","R91.1","Z87.891","S29.019S","Z98.1","I25.118","NO DATA","S36.039A","T79.4XXA","W19.XXXA","Z23.","M54.5","R91.8","Z12.11","K57.30","K64.1","I10.","E78.00","E78.5","K21.9","Z79.899","S01.511A","S36.92XA","S01.81XA","M25.511","I47.1","J96.01","E46.","D64.9","I25.10","M19.90","H90.3","S09.92XA","G47.00","U07.1","H91.90","K43.9","Z95.5","R26.9","Z88.6","Z88.0","Z01.818","Z87.19","Z01.812","Z20.822","M48.04","M25.78","W17.89XA","I49.9","V58.89","W11.XXXD","J01.90","K57.90","K64.9","K43.2","Z86.79","K92.2","S11.81XA","S02.401A","J93.9","D62.","E87.2","Z79.02","Z79.82","R94.31","S02.91XS","S02.92XS","J34.2","M62.830","S31.609A","Z48.1","Z90.81","S20.221A","S27.321A","S27.2XXA","N17.9","F10.10","R41.0","H93.13","Z48.89","H25.13","F41.1","R57.1","I95.9","I51.89","V54.17","S36.09XA","R50.9","J98.4","Z68.26","R10.9"],"date":["2020-11-28","2020-12-03","2020-11-28","2020-11-28","2020-11-28","2020-12-02","2020-11-27","2022-02-01","2022-08-30","2022-02-03","2022-02-03","2022-06-30","2022-09-02","2020-11-25","2020-11-25","2020-11-26","2021-12-02","2021-08-03","2021-07-27","2021-11-12","2021-11-24","2021-11-24","2022-08-30","2022-08-30","2022-02-02","2022-01-13","2022-08-30","2020-11-25","2020-11-25","2021-01-06","2020-12-02","2020-12-22","2020-12-02","2020-12-02","2020-12-02","2022-08-30","2022-01-13","2021-01-13","2021-01-13","2021-02-11","2022-07-21","2022-08-30","2022-08-30","2022-08-30","2020-12-04","2021-05-04","2021-05-04","2021-10-14","2022-09-15","2021-11-08","2021-11-08","2020-11-27","2020-11-27","2020-11-27","2020-11-28","2020-12-22","2020-12-22","2021-08-03","2021-11-12","2021-11-12","2022-09-15","2022-09-15","2020-11-25","2020-11-25","2020-11-25","2020-11-25","2020-12-01","2020-11-25","2020-11-25","2022-02-02","2022-02-02","2021-02-11","2021-02-11","2021-02-11","2021-10-27","2020-11-26","2020-11-26","2021-01-26","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2021-01-13","2021-01-26","2021-02-16","2022-02-02","2020-11-25","2020-11-28","2020-11-28","2020-12-03","2020-11-26","2020-11-29","2020-11-29","2022-09-02","2022-09-02"],"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":[["","68180016013","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","67877014705","TEMAZEPAM","CAP 30MG","30","Select","Select",""],["","16714066202","GABAPENTIN","CAP 300MG","42","Select","Select",""],["","55111015810","OMEPRAZOLE","CAP 20MG","30","Select","Select",""],["","50228046501","NABUMETONE","TAB 500MG","60","Select","Select",""],["","60505317007","OMEGA-3-ACID","CAP 1GM","120","Select","Select",""],["","69097012715","AMLODIPINE","TAB 5MG","90","Select","Select",""],["","57237017190","ROSUVASTATIN","TAB 40MG","90","Select","Select",""],["","65162044110","MECLIZINE","TAB 12.5MG","90","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","24979003902","METOPROL","TAB 100MG ER","90","Select","Select",""],["","69097084507","CYCLOBENZAPR","TAB 5MG","30","Select","Select",""],["","68462015713","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00093551798","SILDENAFIL","TAB 20MG","60","Select","Select",""],["","65862020299","LOSARTAN","TAB 50MG","30","Select","Select",""],["","13107008305","LORAZEPAM","TAB 0.5MG","10","Select","Select",""],["","00591079021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","00069108530","PAXLOVID","TAB 300-100","30","Select","Select",""],["","65862007701","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","58160089052","FLUARIX","INJ 2022-23","0","Select","Select",""],["","65862018601","CLINDAMYCIN","CAP 300MG","21","Select","Select",""],["","80777027399","MODERNA","INJ COVID-19","0","Select","Select",""],["","70010077005","METHOCARBAM","TAB 750MG","84","Select","Select",""],["","72205002405","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","16714044701","AMITRIPTYLIN","TAB 25MG","30","Select","Select",""],["","00591544210","PREDNISONE","TAB 10MG","27","Select","Select",""],["","43386009019","GAVILYTE-G","SOL ","4000","Select","Select",""],["","50111043303","TRAZODONE","TAB 50MG","30","Select","Select",""],["","68180051703","LISINOPRIL","TAB 40MG","30","Select","Select",""],["","63304044990","FENOFIBRATE","TAB 145MG","30","Select","Select",""],["","65862035705","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","65862013399","HYDROCHLOROT","TAB 25MG","30","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","28","Select","Select",""],["","00904645780","DOK","CAP 100MG","28","Select","Select",""],["","45963067696","METOPROLOL","TAB 50MG ER","90","Select","Select",""],["","00904516559","SENNA","TAB 8.6MG","14","Select","Select",""],["","75834010901","CHLORTHALID","TAB 25MG","90","Select","Select",""],["","70677004101","SM","TAB 8.6MG","14","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":""}]}]}