{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YLREBMIKNOSREDNA","gend":1,"add":"RC 8093YAW KEE","city":"CHESTER","state":"VA","zip":"23831-9998","dob":"1986-07-09","age":"","mstatus":"","insh":"2292110*73","cliId":"","pno":"59\/4081858-5","cno":"","email":"","ename":"","eno":"","pphy":"CLAYTON, MELISSA NP","ppno":"804\/717-5300","pcpadd":"STE 117 11601 IRONBRIDGE RD","pcpcity":"CHESTER","pcpstate":"VA","pcpzip":23831,"pcpcounty":"","pcpid":"","pcpname":"IRONBRIDGE FAMILY PRACTICE","plan":"OHP","program":"MEDICAID","lob":"M4","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":["F31.9","F41.8","Z20.828","I10.","R19.7","K51.90","F39.","R41.3","F32.9","R41.0","Z68.20","Z00.00","Z68.22","R79.89","R29.898","K52.9","R11.2","N30.01","F41.9","K80.20","K82.8","E80.6","Z93.2","G47.00","R74.01","K51.919","N30.00","R12.","M60.9","K21.9","M62.81","Z01.419","Z11.51","R10.2","N89.8","Z32.02","R19.00","R94.5","D53.9","R53.83","R11.0","Z68.21","N83.202","N73.6","K51.80","R74.8","R10.11","R17.","K62.5","B35.4","K51.00","K81.1","K76.0","K80.10","K76.9","R18.8","N94.9","D75.89","M60.851","R76.0","K76.89","K51.819","H10.13","R19.09","D69.6","D64.9","F10.10"],"date":["2019-01-03","2019-07-23","2021-03-02","2021-08-31","2021-07-21","2021-07-21","2019-01-04","2019-02-26","2019-03-19","2019-02-26","2021-07-03","2021-04-26","2021-07-04","2021-07-15","2021-06-07","2021-08-05","2021-07-04","2021-07-04","2021-07-03","2021-07-04","2021-07-03","2021-07-04","2021-07-04","2021-07-03","2021-07-04","2021-07-03","2021-07-03","2021-08-12","2021-08-31","2021-08-31","2021-08-31","2020-12-02","2020-12-02","2020-12-02","2020-12-02","2020-12-02","2021-01-14","2021-05-03","2021-05-03","2021-06-10","2021-04-26","2021-04-26","2021-01-14","2021-01-14","2021-07-04","2021-07-04","2021-07-04","2021-07-02","2021-09-09","2019-01-02","2021-04-30","2021-07-03","2021-07-03","2021-07-04","2021-04-29","2021-04-29","2021-04-29","2021-04-29","2021-09-13","2021-06-10","2021-06-10","2021-06-10","2019-03-19","2020-12-23","2021-04-29","2021-04-29","2021-04-29"],"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":[["","29300024319","AMLODIPINE","TAB 10MG","30","Select","Select",""],["","69452015120","VITAMIN","CAP 50000UNT","12","Select","Select",""],["","80777027398","MODERNA","INJ COVID-19","0","Select","Select",""],["","27808003702","HYDROCO\/APAP","TAB 10-325MG","12","Select","Select",""],["","69097084805","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","00185094098","CHOLESTYRAM","POW 4GM","14","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","60","Select","Select",""],["","00406051205","OXYCOD\/APAP","TAB 5-325MG","16","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","30","Select","Select",""],["","00378456105","POT  CHLORIDE","TAB 10MEQ ER","180","Select","Select",""],["","00378668977","PANTOPRAZOLE","TAB 40MG","90","Select","Select",""],["","58160088752","FLUARIX","INJ 2021-22","0","Select","Select",""],["","","FLUCLVX","INJ 2020-21","","Select","Select",""],["","00406324301","HYDROMORPHON","TAB 2MG","12","Select","Select",""],["","65862085901","FAMOTIDINE","TAB 20MG","60","Select","Select",""],["","00406055201","OXYCODONE","TAB 5MG","5","Select","Select",""],["","33332031901","AFLURIA","INJ 2019-20","0","Select","Select",""],["","","METRONIDAZOL","TAB 500MG","","Select","Select",""],["","45802088096","NYSTAT\/TRIAM","CRE ","60","Select","Select",""],["","00316022130","NYSTATIN","CRE 100000","30","Select","Select",""],["","65862001205","SERTRALINE","TAB 50MG","30","Select","Select",""],["","00591024005","LORAZEPAM","TAB 0.5MG","30","Select","Select",""],["","00093007401","ZOLPIDEM","TAB 10MG","30","Select","Select",""],["","62037083001","METOPROL","TAB 25MG ER","30","Select","Select",""],["","00406048410","APAP\/CODEINE","TAB 300-30MG","20","Select","Select",""],["","65862018501","CLINDAMYCIN","CAP 150MG","28","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":""}]}]}