{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" SALOHCINSUTSUJ E","gend":0,"add":" DR KROF SESSEUG DLO 3783                         ","city":"HURLEY                   ","state":"VA","zip":"24620-9998","dob":"1979-08-30","age":"","mstatus":"","insh":"00110715","cliId":"","pno":"6567213846","cno":"","email":"","ename":"","eno":"","pphy":"OWENS, DIA P","ppno":2765977081,"pcpadd":"1721 LOVERS GAP RD,","pcpcity":"Vansant","pcpstate":"VA","pcpzip":246569781,"pcpcounty":"","pcpid":"","pcpname":"THOMPSON FAMILY HEALTH CENTER","plan":"VPHP","program":"MEDICARE","lob":"DSNP","region":"SOUTHWEST","aligned":"Y","ano":"","add2":"                                                  ","add3":"","madd1":"3873 OLD GUESSES FORK RD                          ","madd2":"                                                  ","madd3":"","mcity":"HURLEY                   ","mstate":"VA","mzip":"24620-9998","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z13.9","Z13.89","Z71.89","Z00.8","I10","H91.92","K21.9","J30.9","R05","R51","R53.83","J02.9","R11.0","F41.1","E78.2","Z00.01","Z23","J01.90","R68.84","H65.02","R05.1","E78.5","B36.0","J45.20","H52.12","H52.223","H43.313","U07.1"," "],"date":["2021-06-17","2021-06-17","2021-06-17","2021-06-17","2022-05-04","2019-02-12","2021-10-12","2021-10-12","2019-02-15","2019-02-15","2019-02-15","2022-04-15","2020-03-09","2022-05-04","2021-06-17","2019-06-11","2020-09-25","2021-10-07","2020-10-28","2022-04-04","2022-04-15","2022-05-04","2021-10-12","2021-10-12","2022-08-04","2022-08-04","2022-08-04","2022-08-26","2022-08-26"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"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":[["","68180016006","AZITHROMYCIN","TAB 250MG","6","Select","Select",""],["","68462026290","ROSUVASTATIN","TAB 10MG","90","Select","Select",""],["","13668008130","MONTELUKAST","TAB 10MG","90","Select","Select",""],["","57237016199","OMEPRAZOLE","CAP 20MG","90","Select","Select",""],["","65862020299","LOSARTAN","TAB 50MG","30","Select","Select",""],["","00093317431","ALBUTEROL","FAT E","8.5","Select","Select",""],["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","67877025180","TRIAMCINOLON","CRE 0.001","80","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","60","Select","Select",""],["","00781261305","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","00093227534","AMOX\/K","TAB 875-125","20","Select","Select",""],["","65862018830","ONDANSETRON","TAB 8MG","10","Select","Select",""],["","65862056099","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","59310057922","PROAIR","AER ","8.5","Select","Select",""],["","59746032530","VALACYCLOVIR","TAB 1GM","21","Select","Select",""],["","60432053716","NYSTATIN","SUS 100000","480","Select","Select",""],["","00054418425","DEXAMETHASON","TAB 4MG","11","Select","Select",""],["","00116200116","CHLORHEX","SOL 0.0012","473","Select","Select",""],["","43386035610","HYDROCO\/APAP","TAB 5-325MG","10","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","51672129703","CLOBETASOL","CRE 0.0005","60","Select","Select",""],["","68462024805","RANITIDINE","TAB 150MG","30","Select","Select",""],["","51672404806","CLOTRIM\/BETA","CRE DIPROP","45","Select","Select",""],["","00603158458","PROMETHAZINE","SYP 6.25\/5ML","180","Select","Select",""],["","47781047013","OSELTAMIVIR","CAP 75MG","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":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}