{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NNAYRAMREGOK E","gend":1,"add":"LEMRAH 819TEERTS GNI","city":"BRISTOL","state":"VA","zip":"24201-4064","dob":"1987-05-20","age":"","mstatus":"","insh":"6244838","cliId":"","pno":"0556822740","cno":2766443370,"email":"","ename":"","eno":"","pphy":"ANDREWS, ROY R","ppno":2766695179,"pcpadd":"2195 EUCLID AVE STE 6","pcpcity":"Bristol","pcpstate":"VA","pcpzip":"24201-3655","pcpcounty":"","pcpid":"","pcpname":"TWIN CITY MEDICAL CENTER","plan":"VPHP","program":"MEDICAID","lob":"VPM4","region":"SOUTHWEST","aligned":"","ano":"","add2":"918 HARMELING STREET","add3":"","madd1":"918 HARMELING STREET","madd2":"","madd3":"","mcity":"BRISTOL","mstate":"VA","mzip":"24201-4064","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F31.13","E11.65","Z86.39","L71.9","F41.1","Z87.09","R74.8","R39.9","Z59.0","E11.9","Z79.899","R07.89","R07.9","R06.02","F41.9","R44.0","R11.0","F17.210","F31.9","J45.909","Z79.4","F17.200","O09.90","E10.39","E10.3293","H25.041","R03.0","E10.9","F41.8","O13.9","Z3A.13","Z34.90","Z34.92","G89.11","Z74.3","Z53.21","Z39.1","O24.012","Z3A.24","O26.892","O75.9","Z3A.26","M25.551","O09.522","O26.90","O24.013","Z3A.28","J10.1","R05.9","M79.10","R11.2","Z20.822","J10.89","Z72.0","J11.00","E10.10","R73.9","R06.7","E07.9","E83.51","O09.523","O99.283","O99.333","O99.513","Z3A.30","Z59.01","R53.1","Z73.9","A41.9","J18.9","O98.813","A41.02","J10.08","J15.212","E87.1","O14.93","O24.113","E87.6","O34.211","I34.0","R78.81","B95.62","A41.89","O09.93","J15.9","D72.825","Z88.0","Z59.00","O16.3","R50.9","Z34.83","O14.14","O98.82","D62","Z37.0","O75.3","O24.02","O99.324","Z3A.32","O77.9","O26.893","Z3A.31","O09.33","O99.343","O34.219","O99.013","D64.9","A49.02","O13.3","O14.13","O43.813","O43.893","O36.5130","O14.94","O60.14X0","Z37.9","O77.0","O24.82","O99.344","P28.89","J98.4","R51.9","R53.83","R09.81","F32.89","K08.89","F15.20","R42","Z91.14","Z30.9"],"date":["2021-01-04","2023-01-22","2021-04-20","2021-04-20","2022-12-29","2022-12-29","2022-12-29","2021-05-10","2021-05-10","2022-10-31","2022-05-20","2022-05-20","2022-05-20","2022-05-20","2022-11-23","2022-05-20","2022-11-14","2022-11-27","2022-11-26","2022-11-26","2022-11-19","2022-11-21","2023-01-01","2022-08-12","2022-08-12","2022-08-12","2022-11-17","2022-08-25","2022-11-26","2022-08-25","2022-08-25","2022-11-15","2022-08-26","2022-09-11","2022-11-27","2022-09-11","2022-09-16","2022-10-13","2022-09-20","2022-10-10","2022-10-10","2022-10-13","2022-10-10","2022-10-10","2022-10-10","2022-11-02","2022-10-12","2022-11-10","2023-01-22","2022-10-31","2023-01-22","2023-01-16","2022-11-02","2022-11-06","2022-11-15","2022-11-02","2023-01-22","2022-11-02","2022-11-02","2022-11-02","2022-11-26","2022-11-06","2022-11-21","2022-11-26","2022-11-02","2022-11-02","2022-11-02","2022-11-03","2022-11-13","2022-11-18","2022-11-06","2022-11-06","2022-11-06","2022-11-17","2022-11-06","2022-11-06","2022-11-19","2022-11-06","2022-11-21","2022-11-09","2022-11-17","2022-11-15","2022-11-10","2022-11-10","2022-11-10","2022-11-10","2022-11-17","2022-11-26","2022-11-21","2022-11-14","2022-11-14","2022-11-17","2022-11-17","2022-11-17","2022-11-21","2022-11-17","2022-11-17","2022-11-17","2022-11-26","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-26","2022-11-26","2022-11-26","2022-11-26","2022-11-18","2022-11-18","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-12-10","2022-11-21","2023-01-03","2023-01-22","2022-11-27","2022-12-15","2023-01-03","2023-02-08","2023-01-22","2023-01-22","2023-02-09"],"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":[["","00088221905","LANTUS SOLOS","INJ 100\/ML","15","Select","Select",""],["","08290320550","BD PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","47781030301","NITROFURANTN","CAP 100MG","10","Select","Select",""],["","31604001285","VITAMIN B-6","TAB 100MG","30","Select","Select",""],["","62332003731","LAMOTRIGINE","TAB 25MG","60","Select","Select",""],["","68462013701","OXCARBAZEPIN","TAB 150MG","120","Select","Select",""],["","69238183007","LEVOTHYROXIN","TAB 25MCG","90","Select","Select",""],["","11534016503","FOLIC ACID","TAB 1MG","30","Select","Select",""],["","68180051202","LISINOPRIL","TAB 2.5MG","30","Select","Select",""],["","55111032201","GLIMEPIRIDE","TAB 4MG","30","Select","Select",""],["","00006027731","JANUVIA","TAB 100MG","30","Select","Select",""],["","99073013001","FREESTYLE","MIS LANCETS","100","Select","Select",""],["","00193658621","MICROLET","MIS LANCETS","100","Select","Select",""],["","81131038680","RELION PEN","MIS 31GX6MM","50","Select","Select",""],["","69097014260","ALBUTEROL","AER HFA","6.7","Select","Select",""],["","45802006001","BACITRACIN","OIN 500\/GM","14","Select","Select",""],["","00087040501","POLY-VI-SOL","SOL IRON","50","Select","Select",""],["","00193731221","CONTOUR","TES NEXT","300","Select","Select",""],["","00904699880","DOCUSATE SOD","CAP 100MG","10","Select","Select",""],["","57896010410","ACETAMINOPHE","TAB 325MG","30","Select","Select",""],["","00781324664","ENOXAPARIN","INJ 40\/0.4ML","4","Select","Select",""],["","00904759160","FEROSUL","TAB 325MG","30","Select","Select",""],["","67877032105","IBUPROFEN","TAB 800MG","30","Select","Select",""],["","68382080005","LABETALOL","TAB 300MG","90","Select","Select",""],["","59651029501","NIFEDIPINE","TAB 30MG ER","30","Select","Select",""],["","65162004710","OXYCODONE","TAB 5MG","12","Select","Select",""],["","00002751001","HUMALOG","INJ 100\/ML","10","Select","Select",""],["","00088222033","LANTUS","INJ 100\/ML","10","Select","Select",""],["","80777027399","MODERNA VAC","INJ COVID-19","0.5","Select","Select",""],["","56151210401","PEN NEEDLES","MIS 32GX4MM","100","Select","Select",""],["","59267030401","PFIZER BIVAL","INJ BA4\/BA5","0.3","Select","Select",""],["","40985027384","PRENATAL DHA","CAP 200MG","30","Select","Select",""],["","00002879959","HUMALOG KWIK","INJ 100\/ML","15","Select","Select",""],["","68180067711","OSELTAMIVIR","CAP 75MG","4","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":""}]}]}