{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"MAKENZIE HAMMER","gend":1,"add":"862 GRINDSTONE MOUNTAIN ROAD","city":"SHENANDOAH","state":"VA","zip":"22849-9998","dob":"2002-01-14","age":"","mstatus":"","insh":"7731698*01","cliId":"","pno":5406075333,"cno":5406075333,"email":"","ename":"","eno":"","pphy":"SHIFFLETT, LAURA W NP","ppno":5407134100,"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":"M4","region":"NORTHERN & WINCHESTER","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":["Z11.52","J06.9","R11.2","R51.9","O26.893","Z3A.32","O03.9","N91.2","T78.40XA","NO DATA","O99.891","R55.","Z3A.16","Z88.5","Z88.4","Z88.8","Z91.030","Z91.018","Z91.011","O60.03","O36.8130","O21.9","R19.7","O99.52","J45.909","Z37.9","Z3A.00","I95.9","F31.60","F39.","L65.9","O43.891","Z3A.08","O34.219","R42.","O20.9","F31.9","O99.341","O99.511","Z90.49","Z79.899","Z91.02","K59.09","R33.9","S83.241A","Z3A.38","R10.30","Z32.01","Z36.87","O99.013","D50.9","O99.283","E53.8","Z3A.27","N85.8","Z37.0","Z67.91","Z3A.39","O99.344","O99.334","F17.290","F41.9","Z82.49","N89.8","O36.8120","Z34.02","Z3A.22","O36.8190","Z3A.29","O12.03","Z3A.35","O26.899","R60.9","Z39.1","T63.301A","S93.402A","S89.92XA","Z91.048","M25.569","S93.492A","S80.02XA","Z29.13","O34.211","M25.562","V23.87","Z3A.01","E61.1","O99.019","Z3A.33","Z34.82","Z34.83","R35.0","N94.9","O76.","O99.02","D64.9","Z20.822","O82.","I08.8","O26.891","R10.11","Z3A.13","E86.0","O99.613","K30.","Z3A.37","S83.282A","H00.014","R19.5","K64.8"],"date":["2021-07-09","2021-07-09","2021-07-09","2023-06-11","2023-06-23","2021-11-12","2022-10-14","2022-10-14","2022-10-14","2023-06-23","2023-01-14","2023-01-14","2023-01-14","2023-06-23","2023-06-23","2023-01-14","2023-01-14","2023-01-14","2023-01-14","2021-11-09","2021-11-09","2021-11-09","2021-11-09","2023-06-23","2023-06-23","2021-12-28","2021-12-28","2022-10-13","2022-06-03","2022-10-13","2022-10-13","2022-11-21","2022-11-21","2023-06-23","2022-05-17","2022-09-05","2022-11-09","2022-09-05","2022-09-05","2023-06-23","2022-09-05","2022-09-05","2023-07-27","2023-08-03","2021-08-30","2021-12-20","2022-09-06","2022-10-31","2022-10-31","2023-03-31","2023-03-31","2023-03-31","2023-03-31","2023-03-31","2023-06-23","2023-06-23","2023-06-23","2023-06-23","2023-06-23","2023-06-23","2023-06-23","2023-06-23","2023-06-23","2021-08-31","2021-08-31","2021-08-31","2021-08-31","2021-10-20","2021-10-20","2021-12-03","2021-12-03","2021-12-03","2021-12-03","2023-06-26","2022-07-10","2022-11-09","2022-11-09","2022-11-09","2022-11-09","2022-11-21","2022-11-21","2023-04-05","2023-06-23","2023-09-06","2022-11-11","2022-11-11","2023-04-03","2023-03-28","2023-05-10","2023-06-26","2023-06-26","2021-08-13","2021-08-13","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2022-05-17","2021-07-01","2021-07-01","2021-07-01","2022-04-17","2023-06-11","2023-06-11","2023-06-11","2023-08-22","2023-09-28","2023-08-03","2023-08-03"],"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":[["","00574402435","ERYTHROMYCIN OIN","5MG\/GM","4","Select","Select",""],["","68462030329","HEATHER TAB","0.35MG","28","Select","Select",""],["","00143988750","AMOXICILLIN SUS","400\/5ML","50","Select","Select",""],["","62332009730","ARIPIPRAZOLE TAB","2MG","30","Select","Select",""],["","60505132001","MIDODRINE TAB","2.5MG","60","Select","Select",""],["","00093314705","CEPHALEXIN CAP","500MG","28","Select","Select",""],["","00143980305","DOXYCYCL HYC CAP","100MG","20","Select","Select",""],["","70954005920","PREDNISONE TAB","10MG","5","Select","Select",""],["","11917016408","BACITR ZINC OIN","500\/GM","28","Select","Select",""],["","68001024604","ONDANSETRON TAB","4MG ODT","30","Select","Select",""],["","10006073043","VITAMIN B-","12 1000 MCG","30","Select","Select",""],["","00904672040","ACETAMINOPHEN","500 MG","30","Select","Select",""],["","68001024604","ONDANSETRON ODT","4 MG","16","Select","Select",""],["","50383004224","PREDNISOLONE","15 MG\/5 ML","25","Select","Select",""],["","00093314705","CEPHALEXIN","500 MG","28","Select","Select",""],["","00904725260","SENNA","8.6 MG","60","Select","Select",""],["","65862050320","AMOXICILLIN-CLAVULANATE POTASS","875-125 MG","14","Select","Select",""],["","68001025317","FLUCONAZOLE","150 MG","2","Select","Select",""],["","10702001850","OXYCODONE HCL","5 MG","20","Select","Select",""],["","65162046550","IBUPROFEN","600 MG","30","Select","Select",""],["","00121085416","SULFATRIM","200-40MG\/5","100","Select","Select",""],["","59365512801","PARAGARD T","380-A 380 SQ MM","1","Select","Select",""],["","00574402435","ERYTHROMYCIN","5 MG\/GRAM","3.5","Select","Select",""],["","68462030329","HEATHER","TAB 0.35MG","28","Select","Select",""],["","00143988750","AMOXICILLIN","SUS 400\/5ML","50","Select","Select",""],["","00143980305","DOXYCYCL HYC","CAP 100MG","20","Select","Select",""],["","70954005920","PREDNISONE","TAB 10MG","5","Select","Select",""],["","62332009730","ARIPIPRAZOLE","TAB 2MG","30","Select","Select",""],["","60505132001","MIDODRINE","TAB 2.5MG","60","Select","Select",""],["","11917016408","BACITR ZINC","OIN 500\/GM","28","Select","Select",""],["","68001024604","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00228202950","ALPRAZOLAM","0.5 MG","2","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":""}]}]}