{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SANDRA K PARNELL","gend":1,"add":"142 MANSFIELD ST RM 106","city":"FREDERICKSBURG","state":"VA","zip":"22408-9998","dob":"1963-11-24","age":"","mstatus":"","insh":"2153019*01","cliId":"","pno":"540\/429-4986","cno":"540\/429-4986","email":"","ename":"","eno":"","pphy":"ANSARI, NATHER MD","ppno":"540\/785-9900","pcpadd":"SUITE 200 4510 PLANK RD","pcpcity":"FREDERICKSBURG","pcpstate":"VA","pcpzip":22407,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"540\/784-9960","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R00.1","F10.230","F10.231","R07.9","I10.","E87.6","E83.42","F10.232","F10.10","I16.0","R11.2","R20.0","R29.898","R94.31","R40.4","R52.","E86.0","A04.72","R07.89","R09.02","W19.XXXA","NO DATA","T67.5XXA","F10.239","T50.904A","R55.","T88.7XXA","R42.","T50.901A","T40.601A","R51.9","N39.0","Z82.49","F33.3","H66.92","Z20.822","R07.0","U07.1","A41.9","A09.","R74.01","M25.50","F51.09","Z03.818","R19.7","S05.10XA","R51.","R31.9","R10.9","R79.1","R53.1","I63.9","R68.89","I65.23","R20.2","K35.80","R10.32","R10.84","F10.129","M54.5","Z72.89","S83.92XA","X58.XXXA","Y92.89","Y93.89","Z78.9","N17.9","K62.5","R19.5","S09.90XA","F10.20","R53.83","M94.0","F10.19","F33.1","F10.99","B96.20","F32.9","Z59.0","Z90.710","Z88.6","Z86.73","F19.10","M54.9","G89.29","G44.89","R25.2","I49.9","V62.84","F17.200","Z79.02","R06.9","M25.562","I95.9","R05.8","J02.9","R74.8","F33.2","G81.94","N30.01","E87.1","Z20.828","R29.705","M50.30","M51.36","K76.0","M19.90","Z79.82","Z79.891","Z91.14","R40.20","R25.1","F19.939","R11.10","Z76.5","E11.65","R06.89","R61.","U09.9","R05.9","B09.","K29.20","K44.9","R06.02","M79.606","R68.83","K80.20","Z87.891","H60.92","R22.2","M25.532","N30.00","F10.120","M54.89","F10.929","R53.81","R94.6","R11.11","F11.10","D64.9","I95.89","K64.9","E86.1","E78.5","Z90.49","F10.229","Z88.5","Z80.3","Z45.2","K92.0","K70.10","Z53.29","I25.2","I69.354","M48.07","M51.37","M51.35","M50.90","Z98.1","Z87.440","Z91.81","T40.1X1A","G89.11","R78.0","R41.0","R11.0","E16.2","E16.1","R93.5","R10.13","Z04.9","F41.9","R45.7","F13.20"],"date":["2022-07-03","2022-07-03","2022-09-06","2022-11-08","2022-11-07","2022-11-04","2022-11-04","2022-09-05","2022-11-06","2022-11-06","2022-06-26","2020-06-24","2020-06-26","2022-03-11","2021-08-18","2022-11-03","2021-09-11","2021-07-22","2022-09-02","2022-03-11","2021-09-11","2022-11-07","2021-08-13","2022-09-03","2021-08-30","2021-09-09","2021-08-30","2022-06-26","2021-09-26","2021-09-29","2021-09-29","2022-11-07","2022-09-02","2021-10-10","2022-04-06","2022-04-06","2022-04-06","2022-07-01","2022-07-01","2022-07-01","2022-07-01","2022-08-26","2022-08-26","2022-08-26","2022-11-04","2020-01-06","2020-01-06","2020-04-29","2020-04-30","2020-04-30","2021-09-16","2020-06-21","2020-06-21","2020-06-23","2020-06-23","2020-09-21","2020-09-21","2020-09-21","2021-08-18","2021-08-17","2021-08-17","2021-08-18","2021-08-18","2021-09-11","2021-09-11","2021-08-22","2021-08-28","2021-08-27","2021-08-27","2021-09-11","2021-09-11","2021-09-16","2021-09-18","2022-03-11","2022-03-22","2022-03-22","2022-11-07","2021-07-09","2021-09-16","2022-09-02","2022-09-02","2021-07-09","2021-07-30","2022-09-02","2022-09-02","2022-06-26","2021-08-09","2021-08-16","2021-08-17","2021-08-17","2021-09-08","2021-08-17","2021-08-18","2022-03-11","2022-04-06","2022-07-12","2022-09-02","2022-10-04","2020-06-21","2020-06-21","2020-07-03","2020-06-21","2020-06-21","2020-06-21","2020-06-21","2020-06-21","2021-09-08","2020-07-03","2020-06-21","2020-06-21","2021-09-29","2021-07-30","2022-06-26","2022-06-29","2021-08-20","2021-09-26","2021-09-26","2021-09-26","2022-07-12","2022-07-12","2022-07-12","2022-09-02","2022-11-07","2022-06-29","2022-06-29","2022-06-29","2022-06-29","2020-01-06","2020-08-10","2021-02-24","2021-02-24","2021-07-06","2021-08-26","2021-08-14","2021-09-07","2021-07-06","2021-08-18","2022-06-26","2021-08-26","2021-08-26","2021-08-28","2021-08-28","2021-08-28","2021-08-14","2021-09-08","2021-09-08","2022-09-02","2022-09-02","2022-06-29","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2020-07-03","2020-07-03","2020-07-03","2020-07-03","2020-07-03","2020-07-03","2020-07-03","2020-07-03","2020-08-30","2021-08-16","2021-09-16","2021-09-29","2021-09-29","2022-03-11","2022-03-11","2022-07-01","2022-11-04","2021-08-06","2021-08-08","2021-08-10","2021-08-21"],"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":[["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","10135013201","THIAMINE","TAB 100MG","30","Select","Select",""],["","42858010201","OXYCOD\/APAP","TAB 5-325MG","12","Select","Select",""],["","68180098003","LISINOPRIL","TAB 10MG","30","Select","Select",""],["","50111056001","TRAZODONE","TAB 50MG","30","Select","Select",""],["","27241009706","DULOXETINE","CAP 20MG","60","Select","Select",""],["","00093310905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","69097094312","GABAPENTIN","CAP 300MG","36","Select","Select",""],["","65862035790","CLOPIDOGREL","TAB 75MG","21","Select","Select",""],["","50428038612","ACETAMINOPHN","TAB 500MG","30","Select","Select",""],["","45802005435","TRIAMCINOLON","OIN 0.00025","15","Select","Select",""],["","68382065105","ISOSORB","TAB 60MG ER","30","Select","Select",""],["","10702000801","OXYCODONE","TAB 15MG","9","Select","Select",""],["","68180016011","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00093031101","LOPERAMIDE","CAP 2MG","12","Select","Select",""],["","00378064110","PREDNISONE","TAB 10MG","10","Select","Select",""],["","68585000575","MAG64","TAB 64MG","30","Select","Select",""],["","13107008405","LORAZEPAM","TAB 1MG","5","Select","Select",""],["","42806016005","HYDROXYZ","TAB 25MG","30","Select","Select",""],["","65162036111","FOLIC","TAB 1MG","30","Select","Select",""],["","13668013601","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","07610022640","MELATONIN","TAB 3MG","30","Select","Select",""],["","00005200010","PREVNAR","INJ ","0","Select","Select",""],["","65162068090","PROMETHAZINE","SOL DM","240","Select","Select",""],["","62332002791","LOSARTAN","TAB 25MG","30","Select","Select",""],["","59779060027","CVS","TAB 81MG EC","30","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","37864000052","THERA-M","TAB ","30","Select","Select",""],["","19515080852","FLULAVAL","INJ 2022-23","0","Select","Select",""],["","00597003234","CATAPRES-TTS","DIS 0.2\/24HR","4","Select","Select",""],["","10006070011","VITAMIN","TAB 100MG","30","Select","Select",""],["","00228212750","CLONIDINE","TAB 0.1MG","30","Select","Select",""],["","71093014005","METHOCARBAM","TAB 500MG","20","Select","Select",""],["","65862039010","ONDANSETRON","TAB 4MG ODT","15","Select","Select",""],["","49483060450","IBUPROFEN","TAB 800MG","21","Select","Select",""],["","00574709012","HYDROCORT","SUP 25MG","12","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","20","Select","Select",""],["","52015008001","DIFICID","TAB 200MG","13","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","300","Select","Select",""],["","80681005000","DAILY-VITE","TAB ","30","Select","Select",""],["","54629006702","DAILY","TAB ","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","80681007600","MULTIVITAMIN","TAB ","30","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","00536123441","ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","12","Select","Select",""],["","76385011150","CARVEDILOL","TAB 6.25MG","60","Select","Select",""],["","70377002911","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","00065853302","CIPRODEX","SUS 0.3-0.1%","8","Select","Select",""],["","00591565810","CYCLOBENZAPR","TAB 10MG","20","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}