{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  HPESOJYOCCM D ","gend":0,"add":"NAD 41311DR NTM ET","city":"DANTE","state":"VA","zip":"24237-6914","dob":"1991-02-04","age":"","mstatus":"","insh":"40011400","cliId":"","pno":"7967271280","cno":2764951050,"email":"","ename":"","eno":"","pphy":"BROCKMYRE, ANDREW P","ppno":4239902400,"pcpadd":"240 Medical Park Blvd, Ste 3000","pcpcity":"Bristol","pcpstate":"TN","pcpzip":376207352,"pcpcounty":"","pcpid":"","pcpname":"HOLSTON MEDICAL GROUP PC","plan":"VPHP","program":"MEDICAID","lob":"MLTSS","region":"SOUTHWEST","aligned":"","ano":"","add2":"","add3":"","madd1":"11314 DANTE MTN RD","madd2":"","madd3":"","mcity":"DANTE","mstate":"VA","mzip":"24237-6914","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G82.53","D64.9","R33.9","J96.10","J40","Z43.0","G82.50","J69.0","J18.9","M24.50","Z96.0","N20.0","N13.8","G89.4","Z51.5","N39.0","Z01.818","E86.0","J98.11","R53.1","Z87.442","E55.9","T83.011A","R31.9","T83.098A","R10.30","T83.018A","T83.511A","R19.7","X58.XXXA","G82.20","F41.0","N31.9","M62.838","Z93.0","J18.1","A49.9","F41.9","M25.519","Z79.899","A41.9","Z53.29","M79.2","J16.8","Z72.0","Z20.822","R05","R06.02","E87.6","R91.8","Z95.828","R11.2","Z87.440","K21.9","F17.220","N13.2","R10.9","J84.10","J47.9","K59.00","R65.20","R11.10","F17.290","F11.20","N30.90","R39.9","E53.8","Z92.89","R39.89","R30.0","F32.9","S14.109S","S12.9XXS"],"date":["2022-04-01","2021-12-24","2021-12-24","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2022-04-01","2020-04-19","2021-07-13","2020-11-04","2021-11-04","2020-08-04","2021-11-04","2021-11-04","2021-11-24","2020-02-10","2020-04-19","2020-04-19","2020-04-19","2021-09-30","2020-08-18","2020-09-20","2021-06-30","2021-06-30","2020-09-20","2020-10-28","2021-10-01","2020-10-28","2021-10-01","2020-10-28","2021-03-04","2020-11-04","2021-03-04","2021-11-04","2021-11-04","2021-03-04","2021-03-04","2021-03-04","2021-09-30","2021-10-02","2021-06-30","2021-07-13","2021-09-19","2021-09-19","2021-10-01","2021-09-30","2021-10-01","2021-09-19","2021-09-19","2021-09-30","2021-10-01","2021-09-30","2021-09-30","2021-09-30","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-11-04","2021-12-01","2019-07-19","2019-02-07","2019-02-20","2019-04-08","2019-07-19","2019-07-19","2019-08-07","2019-08-07"],"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":{"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":[["","67877021905","CEPHALEXIN","CAP 500MG","21","Select","Select",""],["","00406012505","HYDROCO\/APAP","TAB 10-325MG","120","Select","Select",""],["","69238131709","PREGABALIN","CAP 300MG","60","Select","Select",""],["","00574018105","POT  CHLORIDE","CAP 10MEQ ER","120","Select","Select",""],["","00143980350","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","00487950103","ALBUTEROL","NEB 0.00083","180","Select","Select",""],["","64380073706","VITAMIN","CAP 50000UNT","2","Select","Select",""],["","43547040750","CLONAZEPAM","TAB 1MG","60","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","20","Select","Select",""],["","65162027250","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","65862053750","LEVOFLOXACIN","TAB 500MG","7","Select","Select",""],["","64679096401","AZITHROMYCIN","TAB 500MG","7","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","49884090738","MEGESTROL","SUS 40MG\/ML","150","Select","Select",""],["","00071101868","LYRICA","CAP 300MG","60","Select","Select",""],["","68462024805","RANITIDINE","TAB 150MG","60","Select","Select",""],["","00904759080","FEROSUL","TAB 325MG","30","Select","Select",""],["","13668001001","CITALOPRAM","TAB 20MG","30","Select","Select",""],["","55111012701","CIPROFLOXACN","TAB 500MG","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":""}]}]}