{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" M ANNOJSNILLUS","gend":1,"add":"NOTSDOOW 171202 TPA NL E","city":"BRISTOL","state":"VA","zip":"24201-9998","dob":"1965-06-24","age":"","mstatus":"","insh":"00600210*32","cliId":"","pno":"72\/6729409-4","cno":"276\/274-9049","email":"","ename":"","eno":"","pphy":"DOCKERY, ELIZABETH J DO","ppno":"276\/628-1186","pcpadd":"STE 300 613 CAMPUS DR","pcpcity":"ABINGDON","pcpstate":"VA","pcpzip":24210,"pcpcounty":"","pcpid":"","pcpname":"","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"SOUTHWEST","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":["F33.1","F33.2","F11.23","F13.20","F43.10","F15.20","F41.1","F51.05","V62.84","I10.","B18.2","R51.","G89.29","E66.9","N39.0","L02.91","R31.9","R53.83","F15.90","Z03.818","G47.33","E66.01","K21.9","F41.8","E55.9","E53.8","Z68.41","I25.119","K29.21","N17.9","Z86.010","K57.30","N20.0","N83.202","Z88.8","Z98.891","Z90.49","Z98.51","F17.210","D75.1","F19.10","B19.20","K29.70","K92.0","F11.20","R87.612","Z87.42","F32.9","L02.511","A41.9","NO DATA","Z20.822","J96.01","J96.02","E44.0","E87.2","R65.20","F19.90","I21.3","F15.10","L03.011","D64.9","F41.9","L40.9","Z86.14","F33.0","Z79.899","R69.","L03.115","I40.9","Z20.9","F10.20","K29.60","K52.9","K59.00","Z98.890","M79.641","M25.531","M25.641","R27.8","R29.898","G47.00","G47.10","R06.83","A09.","K92.2","K57.90","F10.10","R74.0","L02.415","L03.113","I21.4","F51.01","G47.19","R80.9","F17.200","F19.20","R46.89","L40.8","B95.62","F14.20","F12.20","R41.82","T50.901A","R11.0","R77.8","R52.","R53.1","G47.61"],"date":["2022-11-10","2020-08-25","2020-01-13","2020-01-06","2022-05-23","2022-11-08","2020-01-06","2020-01-06","2020-01-06","2022-04-15","2020-01-06","2020-01-06","2021-05-09","2021-11-15","2020-05-26","2020-10-20","2020-02-10","2020-03-26","2021-05-09","2021-01-08","2022-10-03","2022-04-15","2021-12-30","2021-12-30","2022-04-15","2022-04-15","2022-04-15","2022-05-05","2020-05-24","2020-05-25","2020-05-24","2020-05-25","2020-05-24","2020-05-24","2020-05-24","2020-05-24","2020-05-24","2020-05-24","2021-05-11","2020-05-25","2020-05-24","2021-05-12","2020-05-26","2020-05-26","2022-02-03","2020-08-13","2020-08-13","2021-08-06","2021-05-18","2021-11-15","2021-11-18","2021-11-15","2021-11-18","2021-11-18","2021-11-15","2021-11-15","2021-11-15","2022-05-05","2021-11-15","2021-12-14","2021-05-18","2021-05-09","2022-05-05","2021-05-11","2021-05-11","2021-05-11","2022-04-12","2020-05-24","2020-07-08","2021-05-07","2021-11-03","2021-11-19","2020-05-26","2020-05-26","2021-04-29","2021-05-18","2021-05-18","2021-05-18","2021-05-18","2021-05-18","2021-05-18","2020-02-06","2020-02-06","2020-02-06","2020-05-24","2020-05-24","2020-05-25","2020-05-25","2020-05-25","2021-02-10","2021-05-07","2021-11-18","2020-02-06","2020-02-06","2020-05-25","2021-05-12","2020-11-09","2020-11-09","2021-05-12","2021-05-12","2021-11-10","2021-11-19","2021-11-18","2021-11-14","2021-11-14","2021-11-18","2021-11-18","2021-11-18","2022-06-30"],"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":[["","12496120803","SUBOXONE","MIS 8-2MG","7","Select","Select",""],["","69097012203","TOPIRAMATE","TAB 25MG","60","Select","Select",""],["","68180029606","DULOXETINE","CAP 60MG","30","Select","Select",""],["","72205000390","ROSUVASTATIN","TAB 10MG","30","Select","Select",""],["","00536100836","ASPIRIN","CHW 81MG","1","Select","Select",""],["","69097052444","DICLOFENAC","GEL 0.01","100","Select","Select",""],["","00378001805","METOPROL","TAB 25MG","14","Select","Select",""],["","69238153203","CLOBETASOL","CRE 0.0005","30","Select","Select",""],["","51672128401","TRIAMCINOLON","OIN 0.001","15","Select","Select",""],["","68180031906","BUPROPN","TAB 150MG XL","30","Select","Select",""],["","00143980305","DOXYCYCL","CAP 100MG","14","Select","Select",""],["","62332002491","FLUOXETINE","CAP 40MG","30","Select","Select",""],["","65862042005","SMZ\/TMP","TAB 800-160","20","Select","Select",""],["","53746010905","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","45802086866","POLYETH","POW 3350 NF","14","Select","Select",""],["","70000041503","CLEARLAX","POW ","510","Select","Select",""],["","00093227534","AMOX\/K","TAB 875-125","20","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","68462056435","MUPIROCIN","CRE 0.02","30","Select","Select",""],["","54629005701","VITAMIN","TAB 100MG","14","Select","Select",""],["","13668033005","TRAZODONE","TAB 50MG","1","Select","Select",""],["","00168008031","HYDROCORT","CRE 0.025","30","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","14","Select","Select",""],["","65162024709","CHLORTHALID","TAB 25MG","2","Select","Select",""],["","00603533928","PREDNISONE","TAB 20MG","2","Select","Select",""],["","65862001105","SERTRALINE","TAB 25MG","14","Select","Select",""],["","70700015010","OMEPRAZOLE","CAP 20MG","28","Select","Select",""],["","24385016553","ARTHRICREAM","CRE 0.1","85","Select","Select",""],["","00093506101","HYDROXYZ","TAB 25MG","28","Select","Select",""],["","68180098103","LISINOPRIL","TAB 20MG","90","Select","Select",""],["","00603316232","FOLIC","TAB 1MG","14","Select","Select",""],["","69097015815","MELOXICAM","TAB 7.5MG","14","Select","Select",""],["","00536109808","MELATONIN","TAB 5MG","14","Select","Select",""],["","00093221001","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","20","Select","Select",""],["","00093005301","BUSPIRONE","TAB 5MG","60","Select","Select",""],["","43598058230","BUPREN\/NALOX","MIS 8-2MG","7","Select","Select",""],["","65862018730","ONDANSETRON","TAB 4MG","20","Select","Select",""],["","65862056090","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","00143993905","AMOXICILLIN","CAP 500MG","24","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}