{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   IDIEHSREYA M","gend":1,"add":"SEEL 07431DAOR ELLIV","city":"EVINGTON","state":"VA","zip":"24550-9998","dob":"1980-04-23","age":"","mstatus":"","insh":"00500210*79","cliId":"","pno":"24\/4349267-0","cno":"434\/420-7629","email":"","ename":"","eno":"","pphy":"COX, RACHAEL M NP","ppno":"434\/455-5330","pcpadd":"620 COURT STREET","pcpcity":"LYNCHBURG","pcpstate":"VA","pcpzip":24504,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"","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":["F31.12","F31.4","T43.625S","F12.20","L73.9","F15.20","F31.63","F23.","G92.","S09.8XXA","S06.0X9A","S02.2XXA","S01.21XA","F19.10","V62.84","F32.9","F15.10","Z72.0","E87.6","F41.9","F17.210","Z20.822","Z79.899","T14.91XD","K59.00","M54.2","T71.162A","F33.9","L02.419","F31.5","F12.10","F17.290","D72.829","I10.","R76.8","F10.20","F33.2","V58.89","F19.20","M79.672","S90.32XA","S90.122A","T14.91XA","T50.901A","S09.93XA","F33.1","F11.20","F14.21","F10.21","Z01.818","Z20.828","F31.9","F43.10","R41.82","E78.5","S83.91XA","Z01.810","T50.902A","L02.414","Z80.1","Z81.3","T43.592A","R10.11","B19.10","K76.0","NO DATA","T43.222A","T43.211A","R11.2","R29.6","Z82.0","F29.","T88.7XXA","F12.90","Z68.26","M25.561","M19.90","Z81.1"],"date":["2022-11-06","2021-11-17","2021-02-07","2022-01-13","2021-02-07","2022-05-17","2022-11-28","2021-09-02","2021-09-03","2021-09-03","2021-09-03","2021-09-07","2021-09-03","2022-03-23","2022-04-02","2022-01-08","2022-04-02","2021-09-08","2021-09-08","2022-01-08","2022-03-23","2022-03-23","2022-03-23","2021-09-19","2021-10-25","2021-10-25","2021-09-27","2021-11-17","2022-03-19","2022-04-02","2022-04-02","2022-04-02","2022-04-02","2022-04-02","2020-12-31","2020-12-31","2021-11-16","2021-09-19","2021-11-16","2022-01-22","2022-01-22","2022-01-22","2021-09-08","2021-09-08","2021-09-08","2021-09-14","2022-02-03","2022-02-03","2022-02-03","2021-11-08","2020-12-29","2022-03-23","2021-08-23","2021-09-07","2021-10-25","2022-03-23","2021-10-27","2022-01-08","2022-01-08","2022-01-08","2022-03-23","2022-01-08","2020-10-25","2020-10-25","2020-10-25","2020-10-25","2021-09-07","2021-02-03","2021-02-03","2021-09-02","2021-09-02","2021-09-07","2021-09-07","2021-09-08","2021-11-07","2022-03-23","2022-03-23","2022-03-23"],"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":[["","68180072003","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","59148007280","ABILIFY","INJ 400MG","2","Select","Select",""],["","00228212750","CLONIDINE","TAB 0.1MG","30","Select","Select",""],["","57664050183","MIRTAZAPINE","TAB 45MG","30","Select","Select",""],["","70436001102","BUPROPN","TAB 300MG XL","30","Select","Select",""],["","42806016105","HYDROXYZ","TAB 50MG","120","Select","Select",""],["","16571020106","DICLOFENAC","TAB 75MG DR","60","Select","Select",""],["","69315013601","BENZTROPINE","TAB 0.5MG","60","Select","Select",""],["","68180099706","FLUOXETINE","TAB 60MG","30","Select","Select",""],["","24658031205","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","65757030001","VIVITROL","INJ 380MG","1","Select","Select",""],["","43547030503","ARIPIPRAZOLE","TAB 15MG","15","Select","Select",""],["","69584009250","BUSPIRONE","TAB 10MG","90","Select","Select",""],["","00536589588","NICOTINE","DIS 14MG\/24H","28","Select","Select",""],["","00766143050","NICODERM","DIS 14MG\/24H","21","Select","Select",""],["","16729008110","NALTREXONE","TAB 50MG","60","Select","Select",""],["","23155019101","BUPROPION","TAB 75MG","30","Select","Select",""],["","50428394373","CVS","GUM 2MGFRUIT","160","Select","Select",""],["","00574010603","BROMOCRIPTIN","TAB 2.5MG","14","Select","Select",""],["","66993068530","OLANZAPINE","TAB 20MG","60","Select","Select",""],["","45802048678","DOCUSATE","CAP 100MG","30","Select","Select",""],["","60505016601","FLUVOXAMINE","TAB 100MG","60","Select","Select",""],["","68180012202","CEPHALEXIN","CAP 500MG","8","Select","Select",""],["","43547027110","ROPINIROLE","TAB 2MG","30","Select","Select",""],["","59651017301","DOXEPIN","CAP 10MG","30","Select","Select",""],["","65162019050","NAPROXEN","TAB 500MG","60","Select","Select",""],["","70954002010","PRAZOSIN","CAP 2MG","30","Select","Select",""],["","65862048901","QUETIAPINE","TAB 25MG","90","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","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":""}]}]}