{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MONICA   L JOHNSON","gend":1,"add":"PO BOX 272","city":"KINSALE","state":"VA","zip":"22488-9998","dob":"1975-03-30","age":"","mstatus":"","insh":"6047998*01","cliId":"","pno":"804\/238-1431","cno":"","email":"","ename":"","eno":"","pphy":"TSUI, ALLEN Y MD","ppno":"804\/443-5378","pcpadd":"1362 TAPPAHANNOCK BLVD","pcpcity":"TAPPAHANNOCK","pcpstate":"VA","pcpzip":22560,"pcpcounty":"","pcpid":"","pcpname":"TAPPAHANNOCK PRIMARY CARE","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"804\/443-9667","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.2","R52.","L72.0","T78.40XS","M54.12","M54.42","M54.41","G89.29","M54.6","R82.90","Z11.3","N76.0","J01.00","V58.89","Z23.","M50.90","M79.7","L03.114","Z68.35","R30.9","N39.0","N89.8","R35.0","M47.812","S16.1XXS","I89.0","M50.30","M48.02","M47.22","S89.92XA","S89.91XA","S79.919A","Z20.828","V89.2XXD","F32.1","R20.2","E66.01","R35.8","R63.1","D50.9","R53.83","J18.9","S46.912A","M75.22","N91.1","S41.102D","S76.011A","S76.012A","NO DATA","Z30.42","M62.838","R51.9","Z68.34","R07.9","K21.9","Z12.11","M25.561","V89.2XXA","R06.00","E78.2","S89.91XS","N93.9","Z30.09","Z32.01","N92.5","O26.859","Z3A.01","F41.8","Z03.818","Z20.822","R60.0","R53.82","R06.83","B37.3","Z79.899","M50.323","M50.322","S13.4XXA","J32.2","S51.012A","R51.","I10.","Z01.411","R10.2","Z32.02","S16.1XXA","N92.6","J30.1","Z75.2","N91.2","M25.562","M53.2X7","M54.16","M25.552","M17.12","M70.62","M51.37","S96.912A","M76.72","M25.571","M54.32","S93.401A","M54.5","M79.605","W01.0XXA","Y92.512","K04.01","L70.9","E75.5","R30.0","M51.36","M48.07","M51.34"],"date":["2021-08-30","2020-01-10","2020-05-13","2020-05-13","2020-07-20","2020-11-17","2020-11-17","2021-11-22","2020-11-17","2020-12-30","2020-12-30","2021-11-16","2021-04-21","2021-11-03","2021-11-03","2021-10-07","2021-11-03","2021-08-09","2021-11-03","2021-11-16","2021-10-15","2021-10-15","2020-10-28","2020-06-05","2021-02-11","2021-02-11","2021-09-01","2021-09-01","2021-09-01","2021-11-09","2021-11-09","2021-11-09","2020-12-14","2021-01-07","2021-04-02","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-04-02","2021-06-09","2021-06-09","2021-06-29","2021-07-21","2021-11-22","2021-11-22","2021-11-22","2020-10-28","2020-12-18","2020-12-18","2021-10-07","2021-10-18","2021-09-27","2021-09-07","2021-10-30","2021-10-30","2021-10-18","2021-09-27","2021-11-03","2020-10-28","2020-10-28","2020-10-28","2020-09-17","2020-09-17","2020-09-17","2020-12-08","2021-07-19","2021-07-19","2021-10-18","2021-10-18","2021-10-18","2021-05-17","2020-05-19","2020-12-21","2020-12-21","2021-10-19","2021-04-26","2021-07-18","2020-05-01","2020-05-01","2020-08-11","2020-08-11","2021-06-23","2021-05-14","2021-05-17","2021-05-27","2021-06-23","2021-06-23","2019-03-13","2019-02-07","2019-09-16","2019-10-29","2019-02-25","2019-03-13","2019-09-13","2019-03-11","2019-03-11","2019-06-21","2019-04-02","2019-06-10","2019-08-26","2019-01-28","2019-01-28","2019-01-28","2019-06-24","2019-03-12","2019-03-12","2019-06-17","2019-08-16","2019-08-16","2019-10-02"],"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":{"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":[["","","NITROFURANTN","CAP 100MG","","Select","Select",""],["","","CIMETIDINE","TAB 200MG","","Select","Select",""],["","","CIPROFLOXACN"," CIPROFLOXACN ","10","Select","Select",""],["","","AZITHROMYCIN"," AZITHROMYCIN ","6","Select","Select",""],["","00487950125","ALBUTEROL","NEB 0.00083","300","Select","Select",""],["","55111064530","OMEPRAZOLE","CAP 40MG","30","Select","Select",""],["","","FLUTICASONE","SPR 50MCG","","Select","Select",""],["","70710112307","DOXYCYC","TAB 100MG","14","Select","Select",""],["","","CYCLOBENZAPR"," CYCLOBENZAPR ","60","Select","Select",""],["","","PRENATAL","TAB ","","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","25","Select","Select",""],["","","DICLOFENAC"," DICLOFENAC ","60","Select","Select",""],["","42799020801","TINIDAZOLE","TAB 500MG","8","Select","Select",""],["","","HYDROCO\/APAP"," HYDROCO\/APAP ","12","Select","Select",""],["","","METHOCARBAM","TAB 750MG","","Select","Select",""],["","57237001760","DULOXETINE","CAP 20MG","30","Select","Select",""],["","","METRONIDAZOL"," METRONIDAZOL ","4","Select","Select",""],["","","TRIAMT\/HCTZ"," TRIAMT\/HCTZ ","30","Select","Select",""],["","","MELOXICAM"," MELOXICAM ","30","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","28","Select","Select",""],["","","PREDNISONE","TAB 10MG","","Select","Select",""],["","65862086099","FAMOTIDINE","TAB 40MG","30","Select","Select",""],["","43547040111","FUROSEMIDE","TAB 20MG","30","Select","Select",""],["","16714066102","GABAPENTIN","CAP 100MG","90","Select","Select",""],["","","EQ","TAB 200MG","","Select","Select",""],["","","CLINDAMYCIN"," CLINDAMYCIN ","20","Select","Select",""],["","","METHYLPRED"," METHYLPRED ","21","Select","Select",""],["","","MEDROXYPR"," MEDROXYPR ","1","Select","Select",""],["","","FLUCONAZOLE"," FLUCONAZOLE ","2","Select","Select",""],["","00536406301","CL","TAB 28-0.8MG","90","Select","Select",""],["","","LIDOCAINE"," LIDOCAINE ","30","Select","Select",""],["","","SMZ\/TMP","TAB 800-160","","Select","Select",""],["","00555901658","SPRINTEC","TAB 28 DAY","28","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","","DIAZEPAM","TAB 2MG","","Select","Select",""],["","55111017915","TIZANIDINE","TAB 2MG","60","Select","Select",""],["","69543038810","KETOROLAC","TAB 10MG","20","Select","Select",""],["","68382032010","POT  CHLORIDE","TAB 10MEQ ER","30","Select","Select",""],["","31722071390","PANTOPRAZOLE","TAB 40MG","180","Select","Select",""],["","","NAPROXEN"," NAPROXEN ","60","Select","Select",""],["","","LYRICA"," LYRICA ","90","Select","Select",""],["","","NORTRIPTYLIN"," NORTRIPTYLIN ","60","Select","Select",""],["","","TRETINOIN"," TRETINOIN ","45","Select","Select",""],["","","PHENAZOPYRID"," PHENAZOPYRID ","6","Select","Select",""],["","","CHLORHEX"," CHLORHEX ","473","Select","Select",""],["","","TRAMADOL"," TRAMADOL ","15","Select","Select",""],["","","TRIAMCINOLON"," TRIAMCINOLON ","15","Select","Select",""],["","","CLOTRIM\/BETA"," CLOTRIM\/BETA ","30","Select","Select",""],["","","NITROFUR"," NITROFUR ","14","Select","Select",""],["","","APAP\/CODEINE"," APAP\/CODEINE ","25","Select","Select",""],["","","CARISOPRODOL"," CARISOPRODOL ","15","Select","Select",""],["","","BENZONATATE","CAP 200MG","","Select","Select",""],["","","MOMETASONE","SPR 50MCG","","Select","Select",""],["","","NEO\/POLY\/HC","SUS 1% OTIC","","Select","Select",""],["","","DOXYCYCL","CAP 100MG","","Select","Select",""],["","","CITALOPRAM","TAB 10MG","","Select","Select",""],["","","CETIRIZINE","TAB 10MG","","Select","Select",""],["","","CEPHALEXIN","CAP 500MG","","Select","Select",""],["","","PREGABALIN","CAP 100MG","","Select","Select",""],["","","TAGAMET","TAB 200MG","","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":""}]}]}