{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TIPTON KERNS","gend":0,"add":"1875 S EASTSIDE HWY","city":"ELKTON","state":"VA","zip":"22827-9998","dob":"1962-11-09","age":"","mstatus":"","insh":"20030572*01","cliId":"","pno":5404052927,"cno":5404052927,"email":"","ename":"","eno":"","pphy":"PERKINS, JASON F DO","ppno":5402981200,"pcpadd":"13737 SPOTSWOOD TRAIL","pcpcity":"ELKTON","pcpstate":"VA","pcpzip":"22827-9998","pcpcounty":"","pcpid":"","pcpname":"SRMHMG - Sentara East Rockingham Health Center","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CHARLOTTESVILLE WESTERN","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7575798587,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J44.1","I10.","E78.5","G25.81","E66.9","R07.9","I25.10","J44.9","F17.200","R06.02","R05.9","J18.9","E86.0","R53.1","Z20.822","F17.210","Z95.5","Z79.82","Z79.02","R06.2","R07.89","I45.19","J43.9","I25.2","K21.9","F10.129","D69.6","Z79.51","Z68.30","J96.01","Z79.1","Z88.0","Z88.8","Z68.29","Z72.89","M62.81","R26.2","R26.81","R26.89","R06.9","F10.10","E78.2","S80.02XA","J40.","X58.XXXA","Y92.89","Y93.89","R05.1","G62.9","D64.9","Z79.84","R94.31","I25.110","NO DATA","R60.9","I73.9","S80.01XA","J44.0","I11.9","Z12.5","T68.XXXA","R07.81","Z72.0","R09.02","R23.1","E66.01","I21.19","I70.213","F41.9","R60.0","I25.118","M79.89","F17.290","M85.80","J43.2","Z12.2"],"date":["2023-04-10","2023-04-18","2023-04-18","2023-01-05","2023-04-10","2023-04-05","2023-04-18","2023-04-18","2023-04-18","2023-02-23","2023-02-23","2023-02-10","2023-02-10","2023-02-10","2023-04-05","2023-04-16","2023-04-05","2023-04-18","2023-04-16","2023-03-09","2023-04-05","2023-04-16","2023-02-23","2022-05-14","2023-04-05","2022-05-14","2023-02-10","2023-04-18","2023-02-10","2023-04-10","2022-08-01","2022-08-01","2022-08-01","2022-08-01","2022-08-01","2023-02-15","2023-02-15","2023-02-15","2023-02-15","2023-04-05","2022-03-07","2022-06-17","2021-10-31","2021-10-31","2021-10-31","2021-10-31","2021-10-31","2022-10-13","2023-02-10","2023-02-10","2023-02-10","2023-03-09","2022-10-15","2022-02-10","2022-10-20","2022-10-20","2021-10-31","2021-10-31","2021-10-31","2021-12-16","2021-08-07","2022-02-10","2023-04-10","2022-08-01","2023-03-09","2022-02-08","2022-08-01","2022-10-06","2023-04-18","2023-04-16","2023-04-16","2023-04-16","2023-04-05","2023-04-05","2023-04-05","2023-01-13"],"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":[["","57237010099","METOPROL TAR","TAB 25MG","60","Select","Select",""],["","59310057922","PROAIR HFA","AER ","17","Select","Select",""],["","66993058597","FLUTIC\/SALME","AER 250\/50","60","Select","Select",""],["","69097015815","MELOXICAM","7.5 MG","30","Select","Select",""],["","00173069600","ADVAIR DISKU","AER 250\/50","60","Select","Select",""],["","00172572880","FAMOTIDINE","20 MG","60","Select","Select",""],["","00597007541","SPIRIVA","CAP HANDIHLR","30","Select","Select",""],["","43547027010","ROPINIROLE","TAB 1MG","60","Select","Select",""],["","16714068403","SIMVASTATIN","TAB 40MG","30","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","00603533831","PREDNISONE","10 MG","48","Select","Select",""],["","50111078751","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","00093820401","CIMETIDINE","400 MG","60","Select","Select",""],["","27241009990","DULOXETINE","CAP 60MG","30","Select","Select",""],["","67877022310","GABAPENTIN","CAP 300MG","270","Select","Select",""],["","63304069301","CLINDAMYCIN","CAP 300MG","30","Select","Select",""],["","55111019605","CLOPIDOGREL","75 MG","30","Select","Select",""],["","72205002405","ATORVASTATIN","TAB 40MG","30","Select","Select",""],["","67877019805","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","49035046708","ASPIRIN 81MG","CHE WABLE TABLETS","30","Select","Select",""],["","49035007021","EQ MUCUS ER","TAB 600MG","10","Select","Select",""],["","00904679480","ASPIRIN LOW","CHW 81MG","30","Select","Select",""],["","49348075707","SM ASPIRIN","CHW 81MG","30","Select","Select",""],["","00904679480","ASPIRIN","81 MG","30","Select","Select",""],["","49035028338","EQ 12 HR MUC","TAB 600MG","10","Select","Select",""],["","00469260190","MYRBETRIQ","TAB 25MG","30","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","12","Select","Select",""],["","00173071920","FLOVENT HFA","AER 110MCG","12","Select","Select",""],["","47781045704","NITROGLYCERN","SUB 0.4MG","25","Select","Select",""],["","55111028130","LEVOFLOXACIN","750 MG","10","Select","Select",""],["","00378932132","WIXELA INHUB","AER 250\/50","60","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","36","Select","Select",""],["","43547027010","ROPINIROLE HCL","1 MG","60","Select","Select",""],["","00310461612","BREZTRI AEROSPHERE","160-9-4.8","10.7","Select","Select",""],["","43547040111","FUROSEMIDE","20 MG","60","Select","Select",""],["","67877019805","AMLODIPINE BESYLATE","5 MG","30","Select","Select",""],["","00173069600","ADVAIR DISKUS","250-50 MCG","60","Select","Select",""],["","00597007541","SPIRIVA HANDIHALER","18 MCG","30","Select","Select",""],["","72205002405","ATORVASTATIN CALCIUM","40 MG","30","Select","Select",""],["","57237010099","METOPROLOL TARTRATE","25 MG","60","Select","Select",""],["","66993058597","FLUTICASONE-SALMETEROL","250-50 MCG","60","Select","Select",""],["","16714008210","HYDROXYZINE HCL","25 MG","20","Select","Select",""],["","10702002301","OXYCODONE HCL","5 MG","10","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":""}]}]}