{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DALE  L BISHOP","gend":0,"add":"350 IDA LOOP ROAD","city":"LURAY","state":"VA","zip":"22835-9998","dob":"1962-02-25","age":"","mstatus":"","insh":"1912993*01","cliId":"","pno":7033985612,"cno":7033985612,"email":"","ename":"","eno":"","pphy":"DINGESS, JAMES NP","ppno":5406620306,"pcpadd":"190 CAMPUS BLVD SUITE 201","pcpcity":"WINCHESTER","pcpstate":"VA","pcpzip":"22601-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"M4","region":"NORTHERN & WINCHESTER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":8552642066,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S93.602A","S93.402A","X50.1XXA","M54.17","M51.37","G58.9","M54.5","G89.29","M54.16","M51.36","Z13.89","F45.42","M25.569","NO DATA","M47.26","M79.2","Z96.89","G89.4","G83.10","R53.83","I70.299","G90.09","G60.8","M25.551","M62.830","I73.9","R06.02","M79.605","M79.604","I10.","I25.119","M25.552","R35.0","K04.7","L03.211","E78.5","F43.20","E78.2","K76.0","M54.42","F17.219","E66.01","D75.1","Z68.41","M47.816","E88.2","I86.8","Z01.818","J31.0","T48.5X5A","I65.23","Z23.","D17.79","Z20.822","R09.89","M47.817","M47.9","F11.20","M19.012","M19.011","I50.1","I07.1","Z79.891","Z79.899","R09.81","E78.00","E21.1","R39.89","J32.9","F17.200","Z12.2","R05.9","J06.9","F17.210","R91.8","I25.10"],"date":["2021-02-20","2021-02-20","2021-02-20","2021-07-15","2021-07-15","2021-07-15","2021-09-29","2023-03-07","2023-03-07","2023-03-07","2023-03-07","2023-03-07","2023-03-07","2023-03-07","2023-01-25","2021-12-15","2021-12-17","2021-12-15","2023-03-07","2023-03-07","2023-03-07","2023-03-07","2022-09-08","2022-07-14","2022-08-11","2023-03-02","2021-09-29","2022-02-10","2022-02-10","2023-02-09","2023-02-09","2022-12-09","2023-03-03","2021-02-02","2021-02-02","2021-02-02","2021-11-10","2023-02-09","2022-07-29","2022-07-29","2022-07-29","2023-02-09","2022-07-29","2023-02-09","2021-09-29","2021-09-29","2021-09-29","2022-02-10","2023-02-24","2023-02-24","2023-02-09","2021-08-04","2022-02-01","2023-01-17","2022-01-10","2021-01-14","2021-01-14","2023-03-07","2022-10-05","2022-10-05","2022-10-05","2022-10-05","2022-11-11","2022-11-11","2023-01-17","2023-01-17","2023-01-17","2023-01-17","2023-01-17","2023-01-17","2023-01-25","2022-05-11","2022-05-11","2023-01-25","2023-01-25","2023-01-25"],"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":[["","00406052201","OXYCOD\/APAP","TAB 7.5-325","120","Select","Select",""],["","00143924920","AMOX\/K CLAV","TAB 875-125","20","Select","Select",""],["","00071102701","LYRICA CR","TAB 165MG","30","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","30","Select","Select",""],["","68645056354","IBUPROFEN","TAB 800MG","84","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","21","Select","Select",""],["","50383077504","LIDOCAINE","SOL 2% VISC","300","Select","Select",""],["","65162083366","DICLOFENAC","GEL 0.01","300","Select","Select",""],["","68382005105","MELOXICAM","15 MG","30","Select","Select",""],["","59267102504","PFIZER VACC","INJ ADLT RTU","0","Select","Select",""],["","68180096301","ALBUTEROL","AER HFA","8","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","72205007830","PREGABALN ER","TAB 165MG","30","Select","Select",""],["","55111014512","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","31722015290","VALSARTAN","80 MG","30","Select","Select",""],["","00093505898","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","67877069601","CHLORTHALID","TAB 25MG","30","Select","Select",""],["","42806054701","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","55111018015","TIZANIDINE","TAB 4MG","60","Select","Select",""],["","00093216568","NALOXONE HCL","SPR ","2","Select","Select",""],["","29300041519","CYCLOBENZAPR","TAB 10MG","60","Select","Select",""],["","42858000101","OXYCODONE","TAB 5MG","28","Select","Select",""],["","57896044101","BISACODYL","TAB 5MG EC","30","Select","Select",""],["","67457029202","NALOXONE","INJ 0.4MG\/ML","1","Select","Select",""],["","57896048914","POLYETH GLYC","POW 3350 NF","238","Select","Select",""],["","69238115403","EZETIMIBE","10 MG","30","Select","Select",""],["","16729017217","AMITRIPTYLIN","TAB 25MG","30","Select","Select",""],["","68645059090","CLOPIDOGREL","TAB 75MG","30","Select","Select",""],["","29300022019","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","68645051554","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","68382056510","METOPROL SUC","TAB 50MG ER","30","Select","Select",""],["","29300022019","MONTELUKAST SODIUM","10 MG","30","Select","Select",""],["","72205007830","PREGABALIN ER","165 MG","30","Select","Select",""],["","00093505898","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","43547028211","ESCITALOPRAM OXALATE","20 MG","90","Select","Select",""],["","00406052201","OXYCODONE-ACETAMINOPHEN","7.5-325 MG","120","Select","Select",""],["","67877069601","CHLORTHALIDONE","25 MG","30","Select","Select",""],["","59746017310","PREDNISONE","10 MG","39","Select","Select",""],["","68382013201","TAMSULOSIN HCL","0.4 MG","90","Select","Select",""],["","68382056510","METOPROLOL SUCCINATE","50 MG","30","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":""}]}]}