{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JONAS   N RODRIGUEZ","gend":0,"add":"PO BOX 1775","city":"PARKSLEY","state":"VA","zip":"23421-9998","dob":"1983-11-28","age":"","mstatus":"","insh":"2291153*01","cliId":"","pno":"757\/665-6286","cno":"","email":"","ename":"","eno":"","pphy":"HARGIS, NANCY T NP","ppno":"757\/331-1086","pcpadd":"17068 LANKFORD HWY","pcpcity":"EASTVILLE","pcpstate":"VA","pcpzip":23347,"pcpcounty":"","pcpid":"","pcpname":"EASTERN SHORE RURAL HEALTH SYSTEM INC","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/442-9505","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R78.81","G06.1","B95.62","L03.113","B99.9","F19.90","G06.2","F19.10","B19.20","I49.9","I10.","F14.10","Z28.21","E66.9","Z68.42","Z71.3","G83.9","M46.40","M54.2","G89.29","T78.40XA","M46.22","G95.29","F11.23","G47.9","Z68.41","D50.9","F11.20","E55.9","K59.00","E66.01","Z79.891","L03.114","K02.9","Z76.89","G82.50","D64.9","F17.210","G47.33","M25.512","R76.0","M46.32","G95.20","Z87.898","M79.662","I69.959","G89.4","F14.90","F13.20","F10.10","Z72.0","A41.02","Z45.2","C49.5","F14.20","F13.10","B18.2","Z98.1","Z91.81","Z79.2","NO DATA","M79.605","R93.7","L02.414","Z86.14","Z86.19","K02.7","R89.6","M85.88","D69.6","L02.91","M79.606","A41.9","M60.9","M89.9","M60.852","C49.21","S51.801A","S51.802A","Y99.8","R10.30","A41.89","D49.2","M51.16","M25.552","F40.240","L30.9","Z91.19","F17.209","F11.10","Z53.29","Z91.14","F17.200","M25.522","R10.2","S22.001A"],"date":["2022-04-28","2022-08-05","2022-04-28","2021-11-12","2022-02-28","2022-03-16","2022-03-01","2022-03-03","2022-02-20","2022-02-15","2022-04-28","2022-02-13","2021-11-16","2022-04-28","2021-11-16","2022-04-28","2021-10-06","2021-10-06","2021-10-06","2022-03-01","2021-10-06","2021-10-06","2021-10-06","2022-03-03","2021-12-29","2022-04-28","2021-10-10","2022-03-03","2021-10-10","2021-10-10","2022-03-01","2022-03-01","2021-10-19","2022-02-08","2021-09-25","2021-10-07","2021-10-06","2022-03-01","2021-10-06","2021-10-19","2021-11-12","2021-10-06","2021-10-06","2021-10-06","2022-02-13","2022-02-13","2022-03-03","2022-02-28","2022-02-28","2022-02-14","2022-02-28","2022-03-01","2022-03-01","2022-03-01","2022-03-01","2022-03-01","2022-03-16","2022-08-05","2022-03-01","2022-04-20","2022-02-28","2022-02-28","2022-02-20","2022-02-28","2022-02-28","2022-03-15","2022-02-20","2022-02-28","2022-03-11","2022-03-15","2022-02-13","2022-02-13","2022-02-28","2022-03-03","2022-02-15","2022-03-16","2022-03-16","2022-03-16","2022-03-16","2022-03-16","2022-03-15","2022-02-13","2022-02-13","2022-02-13","2022-02-13","2022-02-13","2022-02-13","2022-03-16","2022-02-13","2022-03-04","2022-03-04","2022-03-15","2022-08-05","2022-02-14","2022-02-14","2022-08-05"],"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":[["","42806031250","DOXYCYCL","TAB 100MG","60","Select","Select",""],["","69097081312","GABAPENTIN","CAP 100MG","180","Select","Select",""],["","27808003502","HYDROCO\/APAP","TAB 5-325MG","18","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","10","Select","Select",""],["","","BUPRENORPHIN","SUB 8MG","","Select","Select",""],["","69315090505","LORAZEPAM","TAB 1MG","1","Select","Select",""],["","61748001830","RIFAMPIN","CAP 300MG","20","Select","Select",""],["","60505265301","TRAZODONE","TAB 50MG","60","Select","Select",""],["","00115180301","HYDROXYZ","CAP 25MG","30","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","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":""}]}]}