{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"KATHERINE B HORTON","gend":1,"add":"83 SIMMONS TOWN ROAD","city":"SWORDS CREEK","state":"VA","zip":"24649-9998","dob":"1966-05-09","age":"","mstatus":"","insh":"20051795*01","cliId":"","pno":2767010954,"cno":2767010954,"email":"","ename":"","eno":"","pphy":"ROBERTS, AMY L NP","ppno":2769646771,"pcpadd":"1 CLINIC DR,","pcpcity":"RICHLANDS","pcpstate":"VA","pcpzip":"24641-9998","pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","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":["K62.5","K57.30","K64.0","K63.89","K21.9","G47.33","E66.8","G47.10","Z01.411","Z12.72","R10.2","E89.40","Z12.31","Z13.820","N76.1","R30.0","R10.30","F43.21","S91.311A","W26.8XXA","R33.9","Z88.9","N32.89","D64.9","D50.9","E06.3","M54.5","M54.2","E66.01","G89.29","J01.00","J02.9","E11.9","Z71.3","Z01.818","E78.1","E55.9","E03.9","F41.9","G44.89","N39.0","R41.3","J30.2","M25.50","E78.2","G43.909","J30.9","G62.9","Z79.84","H25.813","H10.45","R03.0","F32.9","M79.671","M79.672","E10.42","M20.12","D21.22","R05.9","G44.229","Z11.52","R05.1","E11.40","K52.9","K64.8","Z90.710","Z90.49","R07.9","Z87.898","Z87.19","R19.7","L03.116","Z86.16","G47.30","Z88.8","Z79.899","H53.8","B37.9","NO DATA","Z86.59","Z51.0","U07.1","Z20.822","R09.81","H65.01","N30.81","J06.9","R52.","N30.80","I10.","J20.9","R06.2","R05.","Z01.810","I51.7","K46.9","N30.90","M54.16","M72.2","R53.1","Z68.38","Z87.891","E78.5","H10.022","S90.851A","B37.2","Z11.59"],"date":["2021-01-28","2021-02-10","2021-01-28","2021-01-28","2023-08-22","2023-07-19","2021-02-18","2021-02-18","2021-05-10","2021-05-10","2021-07-22","2021-05-10","2021-05-10","2021-05-10","2021-05-10","2021-07-01","2021-06-01","2022-04-18","2021-06-24","2021-06-24","2021-07-22","2021-07-22","2021-07-22","2021-07-22","2022-11-23","2021-09-03","2021-09-03","2021-09-03","2022-11-23","2023-08-22","2023-08-11","2023-01-09","2023-08-22","2022-03-08","2022-07-13","2022-11-23","2022-11-23","2023-08-22","2022-11-23","2022-11-23","2023-08-22","2022-09-01","2022-11-23","2023-08-22","2023-08-22","2023-08-22","2023-08-22","2023-08-22","2023-03-24","2023-03-24","2023-03-24","2023-03-24","2021-04-22","2023-06-01","2023-09-11","2023-06-01","2023-03-21","2022-07-21","2022-07-13","2022-09-01","2023-08-11","2023-08-11","2022-07-21","2021-02-10","2021-02-10","2021-06-01","2021-06-01","2021-10-23","2021-01-05","2021-01-05","2021-01-19","2021-07-21","2021-10-23","2021-10-23","2022-07-21","2022-07-21","2021-10-23","2021-10-27","2021-10-27","2021-10-27","2021-11-23","2023-08-14","2022-01-12","2023-03-07","2023-03-07","2021-07-07","2021-03-24","2021-03-24","2021-07-07","2021-07-07","2021-12-29","2021-08-17","2021-08-17","2021-01-25","2021-01-25","2021-06-09","2021-06-09","2021-11-29","2023-09-11","2022-07-19","2022-07-21","2022-07-21","2022-07-21","2023-04-20","2023-06-01","2023-08-22","2023-08-22"],"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":[["","68462010630","ONDANSETRON","TAB 8MG","40","Select","Select",""],["","69452015120","VITAMIN D","2 1250 MCG","4","Select","Select",""],["","68001025204","FLUCONAZOLE","100 MG","3","Select","Select",""],["","69584009250","BUSPIRONE","TAB 10MG","90","Select","Select",""],["","45802086802","POLYETH GLYC","POW 3350 NF","238","Select","Select",""],["","13668000905","CITALOPRAM","TAB 10MG","30","Select","Select",""],["","65862057490","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","62175013643","OMEPRAZOLE","40 MG","30","Select","Select",""],["","59779061270","ALLERGY RELF","TAB 10MG","30","Select","Select",""],["","00378180010","LEVOTHYROXIN","TAB 25MCG","30","Select","Select",""],["","00378306605","FENOFIBRATE","145 MG","30","Select","Select",""],["","59779030602","CVS PURELAX","POW ","238","Select","Select",""],["","11534018701","BUT\/APAP\/CAF","CAP ","60","Select","Select",""],["","67877057305","BENZONATATE","CAP 100MG","30","Select","Select",""],["","00591352530","LIDOCAINE","5 %","30","Select","Select",""],["","00536116361","MUCUS RELIEF","TAB 600MG ER","40","Select","Select",""],["","51991074690","DULOXETINE","CAP 20MG","30","Select","Select",""],["","69238207707","PROPRANOLOL","TAB 10MG","180","Select","Select",""],["","45802065078","LORATADINE","TAB 10MG","30","Select","Select",""],["","50428234554","URINARY PAIN","TAB 95MG","12","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","25","Select","Select",""],["","65862042005","SMZ\/TMP DS","TAB 800-160","20","Select","Select",""],["","68462038730","SOLIFENACIN","TAB 10MG","30","Select","Select",""],["","00093354143","ESTRADIOL","0.01 %","42.5","Select","Select",""],["","65862064163","AZITHROMYCIN","250 MG","6","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","7","Select","Select",""],["","00093101042","MUPIROCIN","OIN 0.02","22","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","00006027731","JANUVIA","TAB 100MG","30","Select","Select",""],["","57599000200","FREESTYLE","MIS READER","1","Select","Select",""],["","68001041103","GABAPENTIN","600 MG","120","Select","Select",""],["","70377002711","ATORVASTATIN","TAB 10MG","30","Select","Select",""],["","68001033203","LISINOPRIL","2.5 MG","90","Select","Select",""],["","68001036206","CEFDINIR","300 MG","20","Select","Select",""],["","65162052110","PROMETHAZINE","TAB 25MG","20","Select","Select",""],["","70010049110","METFORMIN","TAB 500MG ER","60","Select","Select",""],["","59310057922","PROAIR HFA","AER ","8","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","24658031205","DOXYCYCL HYC","TAB 100MG","20","Select","Select",""],["","65862001501","AMOXICILLIN","TAB 875MG","20","Select","Select",""],["","70710122600","AMITRIPTYLIN","TAB 25MG","30","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","16","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","53885024450","ONETOUCH","TES ULTRA","50","Select","Select",""],["","68001042300","NITROFURANTN","CAP 100MG","30","Select","Select",""],["","00002143480","TRULICITY","1.5 MG\/0.5","2","Select","Select",""],["","16571040250","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","00378064205","PREDNISONE","TAB 20MG","10","Select","Select",""],["","47781030801","NITROFUR MAC","CAP 100MG","97","Select","Select",""],["","53885000810","ONETOUCH DEL","MIS PLUS 33G","100","Select","Select",""],["","00904671740","CETIRIZINE HCL","10 MG","30","Select","Select",""],["","00143980305","DOXYCYCLINE HYCLATE","100 MG","20","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4 MG","21","Select","Select",""],["","46122067264","OLOPATADINE HCL","0.1 %","5","Select","Select",""],["","53885014301","ONETOUCH DELICA","33 GAUGE","100","Select","Select",""],["","70010049105","METFORMIN HCL ER","500 MG","60","Select","Select",""],["","68001036103","MONTELUKAST SODIUM","10 MG","30","Select","Select",""],["","53885027150","ONETOUCH VERIO TEST STRIP","","50","Select","Select",""],["","68001042300","NITROFURANTOIN MONO-MACRO","100 MG","30","Select","Select",""],["","00591555401","PROPRANOLOL HCL","10 MG","60","Select","Select",""],["","16729044717","LEVOTHYROXINE SODIUM","25 MCG","30","Select","Select",""],["","67877052890","SOLIFENACIN SUCCINATE","10 MG","30","Select","Select",""],["","70436015542","PROMETHAZINE-DM","6.25-15\/5","120","Select","Select",""],["","60505257808","ATORVASTATIN CALCIUM","10 MG","90","Select","Select",""],["","53885024450","ONETOUCH ULTRA TEST STRIP","","50","Select","Select",""],["","61314065605","CIPROFLOXACIN HCL","0.3 %","5","Select","Select",""],["","53885000075","","","50","Select","Select",""],["","00002149580","MOUNJARO","5 MG\/0.5ML","2","Select","Select",""],["","68462010630","ONDANSETRON TAB","8MG","40","Select","Select",""],["","60505257808","ATORVASTATIN TAB","10MG","90","Select","Select",""],["","68462038730","SOLIFENACIN TAB","10MG","30","Select","Select",""],["","69452015120","VITAMIN D CAP","50000UNT","48","Select","Select",""],["","00378180010","LEVOTHYROXIN TAB","25MCG","30","Select","Select",""],["","45802065078","LORATADINE TAB","10MG","30","Select","Select",""],["","68180051201","LISINOPRIL TAB","2.5MG","30","Select","Select",""],["","69584009150","BUSPIRONE TAB","5MG","90","Select","Select",""],["","59651000305","OMEPRAZOLE CAP","40MG","30","Select","Select",""],["","00378306605","FENOFIBRATE TAB","145MG","30","Select","Select",""],["","00591352530","LIDOCAINE PAD","5%","30","Select","Select",""],["","70010049110","METFORMIN TAB","500MG ER","60","Select","Select",""],["","69097081312","GABAPENTIN CAP","100MG","90","Select","Select",""],["","70710113908","FLUCONAZOLE TAB","150MG","6","Select","Select",""],["","65862001501","AMOXICILLIN TAB","875MG","20","Select","Select",""],["","53746010901","HYDROCO\/APAP TAB","5-325MG","16","Select","Select",""],["","70710122501","AMITRIPTYLIN TAB","10MG","30","Select","Select",""],["","57599000101","FREESTYLE KIT SENSOR","","2","Select","Select",""],["","66993000210","ESTRADIOL CRE","0.01%","42","Select","Select",""],["","00002143380","TRULICITY INJ","0.75\/0.5","2","Select","Select",""],["","00591555401","PROPRANOLOL TAB","10MG","180","Select","Select",""],["","00169413212","OZEMPIC INJ","2\/1.5ML","2","Select","Select",""],["","57599000200","FREESTYLE MIS READER","","1","Select","Select",""],["","68001042300","NITROFURANTN CAP","100MG","90","Select","Select",""],["","53885024450","ONETOUCH TES ULTRA","","50","Select","Select",""],["","68001036103","MONTELUKAST TAB","10MG","30","Select","Select",""],["","00904671740","CETIRIZINE TAB","10MG","30","Select","Select",""],["","53885013610","ONETOUCH MIS LANCETS","","100","Select","Select",""],["","53885044801","ONETOUCH KIT ULTRA","2","1","Select","Select",""],["","65862042005","SMZ\/TMP DS TAB","800-160","20","Select","Select",""],["","68180016011","AZITHROMYCIN TAB","250MG","6","Select","Select",""],["","53885000810","ONETOUCH DEL MIS PLUS","33G","100","Select","Select",""],["","47781030801","NITROFUR MAC CAP","100MG","37","Select","Select",""],["","67877054360","CEFDINIR CAP","300MG","20","Select","Select",""],["","00378064205","PREDNISONE TAB","20MG","10","Select","Select",""],["","53885001110","ONETOUCH DELICA PLUS LANCET","30 GAUGE","100","Select","Select",""],["","69315011610","FUROSEMIDE","20 MG","30","Select","Select",""],["","82607066026","FLOWFLEX COVID-","19 AG HOME TEST","8","Select","Select",""],["","29300042010","AMITRIPTYLINE HCL","25 MG","30","Select","Select",""],["","00713067831","NYSTATIN","100000\/G","30","Select","Select",""],["","00006505506","LAGEVRIO (EUA)","200 MG","40","Select","Select",""],["","66993001968","ALBUTEROL SULFATE HFA","90 MCG","18","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":""}]}]}