{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JULIE WILSON","gend":1,"add":"72B ST IVES CT","city":"MATHEWS","state":"VA","zip":"23109-9998","dob":"1973-01-21","age":"","mstatus":"","insh":"1554801*01","cliId":"","pno":8042100724,"cno":8042100724,"email":"","ename":"","eno":"","pphy":"DUTTON, KRISTINE L FNP","ppno":8046932720,"pcpadd":"7547 MEDICAL DRIVE SUITE 2200,","pcpcity":"GLOUCESTER","pcpstate":"VA","pcpzip":"23061-9998","pcpcounty":"","pcpid":"","pcpname":"Riverside Mathews Medical Center","plan":"OHP","program":"MEDICAID","lob":"M4","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F11.20","U07.1","NO DATA","J96.01","J80.","J12.81","A41.9","R65.20","R79.1","D72.819","Z99.81","I82.819","N39.0","I82.811","B37.0","Z98.84","K31.84","Z23.","R19.06","Z13.220","Z11.59","Z11.4","Z13.1","Z12.11","Z13.29","E61.1","F41.1","Z12.31","M70.51","I83.91","Z90.49","M25.561","R06.02","E87.6","E83.31","D50.8","R00.0","R60.0","K59.00","Z79.899","R51.9","A41.89","E66.9","E83.39","E86.0","G89.29","B96.89","Z68.35","K44.9","Z86.2","M25.551","M25.552","R53.83","E66.01","Z68.37","K59.09","J30.2","E55.9","K21.9","R50.9","M54.42","M54.41","L03.115","R09.02","Z01.419","M79.604","D64.9","M54.9","M25.361","M25.461","M85.861","D50.9","S83.241A","M17.11","E11.9","E07.9","Z86.718","Z68.41","N39.498","L08.9","G89.21","R39.81","R26.89","S83.231A","S83.281A","S83.31XA","Z01.810","Z01.812","Z01.818","E66.8"],"date":["2023-09-28","2022-01-13","2023-06-28","2022-01-09","2022-01-09","2022-01-09","2022-01-07","2022-01-07","2022-01-09","2022-01-09","2022-01-09","2022-01-09","2022-01-09","2022-01-13","2022-01-13","2023-08-24","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-06-14","2022-12-10","2022-12-10","2022-12-10","2023-08-24","2021-12-30","2022-01-03","2022-01-03","2021-12-11","2021-12-11","2021-12-11","2021-12-11","2023-08-23","2021-12-26","2021-12-30","2023-08-23","2021-12-30","2021-12-30","2023-08-24","2021-12-30","2021-12-30","2023-06-28","2023-08-29","2023-02-17","2023-02-17","2023-03-21","2023-02-17","2023-02-17","2023-08-24","2023-02-17","2023-08-17","2023-08-23","2021-11-17","2022-08-06","2022-08-09","2022-08-09","2021-12-30","2023-03-21","2023-05-15","2023-05-15","2022-07-30","2023-05-18","2023-05-18","2023-05-18","2023-08-24","2023-08-23","2023-08-29","2023-08-29","2023-08-23","2023-08-29","2023-08-29","2023-08-24","2023-08-17","2023-08-17","2023-09-19","2023-09-19","2023-09-06","2023-09-06","2023-09-06","2023-08-31","2023-08-31","2023-08-31","2023-08-29"],"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":[["","65862001205","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00781286810","OMEPRAZOLE","20 MG","30","Select","Select",""],["","43386048024","ORPHENADRINE","TAB 100MG ER","60","Select","Select",""],["","57896022201","ACETAMINOPHE","TAB 500MG","100","Select","Select",""],["","57896040101","DOCUSATE SOD","CAP 100MG","30","Select","Select",""],["","45802065087","LORATADINE","10 MG","30","Select","Select",""],["","68462015813","ONDANSETRON","TAB 8MG ODT","50","Select","Select",""],["","69315011710","FUROSEMIDE","TAB 40MG","30","Select","Select",""],["","57896040101","STOOL SOFTNR","CAP 100MG","30","Select","Select",""],["","68382004110","PROMETHAZINE","TAB 25MG","30","Select","Select",""],["","00054418625","DEXAMETHASON","TAB 6MG","4","Select","Select",""],["","50458058030","XARELTO","TAB 10MG","30","Select","Select",""],["","66689000816","NYSTATIN","SUS 100000","200","Select","Select",""],["","52817033210","CYCLOBENZAPR","TAB 10MG","45","Select","Select",""],["","00093506101","HYDROXYZ HCL","TAB 25MG","60","Select","Select",""],["","65862019201","FLUOXETINE","CAP 10MG","30","Select","Select",""],["","00591352530","LIDOCAINE","PAD 0.05","30","Select","Select",""],["","67877061115","TIZANIDINE","CAP 4MG","12","Select","Select",""],["","00904672040","ACETAMIN","TAB 500MG","100","Select","Select",""],["","46581083006","SALONPAS GEL","PAD 0.04","6","Select","Select",""],["","60219170805","PREDNISONE","TAB 20MG","7","Select","Select",""],["","68180012202","CEPHALEXIN","500 MG","30","Select","Select",""],["","42806071405","BENZONATATE","CAP 100MG","21","Select","Select",""],["","80681009900","FOLIC ACID","0.4 MG","30","Select","Select",""],["","57896040101","DOCUSATE SODIUM","100 MG","90","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","70000009201","ACETAMINOPHEN","325 MG","90","Select","Select",""],["","65862001501","AMOXICILLIN","875 MG","14","Select","Select",""],["","69097015812","MELOXICAM","7.5 MG","30","Select","Select",""],["","30142069791",""," ","6","Select","Select",""],["","53746010901","HYDROCODONE-ACETAMINOPHEN","5 MG-325MG","12","Select","Select",""],["","57664037718","TRAMADOL HCL","50 MG","12","Select","Select",""],["","50458058030","XARELTO TAB","10MG","30","Select","Select",""],["","00054418625","DEXAMETHASON TAB","6MG","4","Select","Select",""],["","55111015810","OMEPRAZOLE CAP","20MG","30","Select","Select",""],["","66689000816","NYSTATIN SUS","100000","200","Select","Select",""],["","65862019201","FLUOXETINE CAP","10MG","30","Select","Select",""],["","68462015813","ONDANSETRON TAB","8MG ODT","50","Select","Select",""],["","67877061115","TIZANIDINE CAP","4MG","12","Select","Select",""],["","60219170805","PREDNISONE TAB","20MG","7","Select","Select",""],["","00093506101","HYDROXYZ HCL TAB","25MG","60","Select","Select",""],["","52817033210","CYCLOBENZAPR TAB","10MG","45","Select","Select",""],["","67877021905","CEPHALEXIN CAP","500MG","28","Select","Select",""],["","46581083006","SALONPAS GEL PAD","4%","6","Select","Select",""],["","00904672040","ACETAMIN TAB","500MG","100","Select","Select",""],["","00591352530","LIDOCAINE PAD","5%","30","Select","Select",""],["","42806071405","BENZONATATE CAP","100MG","21","Select","Select",""],["","51672208002","TERBINAFINE","1 %","30","Select","Select",""],["","69097085907","TERBINAFINE HCL","250 MG","14","Select","Select",""],["","40985027062","VITAMIN D","3 25 MCG","30","Select","Select",""],["","10702001850","OXYCODONE HCL","5 MG","20","Select","Select",""],["","45802081184","NALOXONE HCL","4 MG","2","Select","Select",""],["","57896098101","ASPIRIN EC","81 MG","56","Select","Select",""],["","67877032101","IBUPROFEN","800 MG","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":""}]}]}