{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"  AILEHSESOR E ","gend":1,"add":" AILEHSTTEREVE","city":"EMPORIA","state":"VA","zip":"23847-9998","dob":"1955-10-10","age":"","mstatus":"","insh":"07200210*89","cliId":"","pno":"03\/2526807-8","cno":"","email":"","ename":"","eno":"","pphy":"ANDERSON, MICHAEL S MD","ppno":"434\/634-6101","pcpadd":"6 DOCTORS DRIVE","pcpcity":"EMPORIA","pcpstate":"VA","pcpzip":23847,"pcpcounty":"","pcpid":"","pcpname":"EMPORIA MEDICAL ASSOCIATES PC","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"CENTRAL","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F25.0","F20.0","F20.9","I10.","F32.9","L30.9","F17.210","Z71.6","R63.6","Z68.1","M25.562","D50.9","K21.9","E03.9","F32.0","R25.1","G60.9","F33.41","F34.1","S40.019A","S60.511A","Z23.","I73.9","F31.63","E07.9","D64.9","M79.602","G47.00","F25.9","F43.20","F17.200","Z01.411","Z12.31","R32.","R10.9","N39.0","H25.13","M79.604","M19.90","Z79.899","Z88.8","F31.9","G47.30","Z88.6","G43.909","F60.0"],"date":["2021-12-07","2021-12-19","2021-11-18","2021-11-19","2021-03-04","2020-11-30","2021-03-04","2021-03-04","2021-03-04","2021-03-04","2021-11-17","2021-11-19","2021-11-19","2021-11-19","2020-12-14","2021-03-04","2021-03-04","2019-12-16","2019-01-09","2019-01-09","2019-01-09","2019-01-09","2019-01-09","2019-07-07","2019-07-07","2019-07-07","2019-07-30","2019-07-30","2019-07-30","2019-09-09","2019-07-04","2019-09-11","2019-09-11","2019-09-11","2019-09-11","2019-02-13","2019-09-04","2019-02-27","2019-07-03","2019-07-03","2019-07-03","2019-07-03","2019-07-03","2019-07-03","2019-07-03","2019-07-03"],"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":[["","","MIRTAZAPINE","TAB 7.5MG","","Select","Select",""],["","","HALOPER"," HALOPER ","1","Select","Select",""],["","65862049101","QUETIAPINE","TAB 100MG","60","Select","Select",""],["","45802046564","KETOCONAZOLE","SHA 0.02","120","Select","Select",""],["","50428693430","SPECTRAVITE","TAB ADVANCED","100","Select","Select",""],["","","OLANZAPINE","TAB 2.5MG","","Select","Select",""],["","00005445176","CENTRUM","TAB ADULTS","30","Select","Select",""],["","","HALOPERIDOL"," HALOPERIDOL ","60","Select","Select",""],["","","IBUPROFEN"," IBUPROFEN ","40","Select","Select",""],["","62175061743","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","59779048462","PAIN","TAB 500MG","100","Select","Select",""],["","","TRAZODONE"," TRAZODONE ","30","Select","Select",""],["","","DICLOFENAC"," DICLOFENAC ","100","Select","Select",""],["","","AMLODIPINE"," AMLODIPINE ","30","Select","Select",""],["","","MUPIROCIN"," MUPIROCIN ","22","Select","Select",""],["","","SERTRALINE"," SERTRALINE ","90","Select","Select",""],["","","BENZTROPINE"," BENZTROPINE ","60","Select","Select",""],["","","CEPHALEXIN"," CEPHALEXIN ","10","Select","Select",""],["","","ACETAMINOPHN"," ACETAMINOPHN ","100","Select","Select",""],["","","VOLTAREN"," VOLTAREN ","100","Select","Select",""],["","","BACLOFEN"," BACLOFEN ","90","Select","Select",""],["","","RISPERIDONE"," RISPERIDONE ","30","Select","Select",""],["","","RANITIDINE"," RANITIDINE ","60","Select","Select",""],["","","AMOX\/K"," AMOX\/K ","20","Select","Select",""],["","","OXYBUTYNIN","TAB 5MG","","Select","Select",""],["","","TRIAMCINOLON","CRE 0.001","","Select","Select",""],["","","HYDROXYZ","CAP 50MG","","Select","Select",""],["","","CVS","GUM 2MGFRUIT","","Select","Select",""],["","","NICOTINE","GUM 2MG CINN","","Select","Select",""],["","","NAPROXEN","TAB 500MG","","Select","Select",""],["","","EAR","DRO 0.065","","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":""}]}]}