{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"   NERAKINIRAC M","gend":1,"add":"OB OP803 X","city":"RICHLANDS","state":"VA","zip":"24641-9998","dob":"1970-08-31","age":"","mstatus":"","insh":"2429110*49","cliId":"","pno":"43\/6720864-5","cno":"","email":"","ename":"","eno":"","pphy":"HARMAN, NICHOLAS DO","ppno":"276\/889-3700","pcpadd":"495 EAST MAIN ST","pcpcity":"LEBANON","pcpstate":"VA","pcpzip":24266,"pcpcounty":"","pcpid":"","pcpname":"HOLSTON MEDICAL GROUP PC","plan":"OHP","program":"MEDICAID","lob":"M4","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":["I10.","G47.30","E66.9","R06.02","F31.13","F43.10","F60.3","F90.2","E88.81","Z01.818","N85.2","N85.7","E87.6","R94.4","NO DATA","E55.9","D64.9","N17.8","N39.0","I12.9","E11.9","F31.9","F41.9","M25.60","R30.0","M79.606","Z20.2","G47.33","R06.9","G47.10","Z01.411","Z12.4","R10.2","Z12.39","Z68.33","R00.2","R42.","Z20.828","J01.90","R76.8","K21.9","E04.1","D50.9","R07.9","R33.9","N39.46","N31.8","M54.5","T78.40XA","Z12.11","K22.2","D12.0","K57.30","M47.26","K91.870","N70.11","R73.03","N94.6","R10.32","D25.9","Z23.","M79.7","R79.82","Z78.0","Z03.818","Z87.19","Z88.2","G24.01","K64.8","N19.","E66.01","Z68.31","R10.9","Z86.010","K29.50","K31.89","K44.9","J01.00","R05.1","K76.0","R13.11","R53.83","R22.9","R31.29","N92.0","Z68.35","Z12.31","M54.2","T74.91XA","M13.0","R41.3","E53.8","P74.22","D31.32","J01.80","F41.1","R32.","N39.3","H92.03","J00.","N92.5","K59.01","R13.19","R10.84","R60.9","D49.2","B07.8","R03.0","R53.82","M79.643","R31.9","R60.0","J68.3","R35.1","R94.5","F90.9","R06.00","F32.0","F30.11"],"date":["2021-12-13","2021-07-23","2020-09-23","2020-05-20","2021-12-22","2021-12-22","2021-12-22","2021-12-22","2021-12-12","2020-11-04","2020-11-10","2020-11-10","2021-12-13","2021-04-06","2021-12-13","2021-12-13","2021-12-13","2021-12-13","2021-12-13","2021-07-13","2021-11-11","2021-11-11","2021-11-11","2021-08-28","2020-06-26","2020-03-16","2020-03-16","2021-05-25","2020-03-19","2021-02-11","2020-06-26","2020-06-26","2020-11-10","2020-06-26","2020-06-26","2020-07-21","2020-12-29","2020-11-04","2020-10-02","2020-10-02","2021-05-25","2021-04-08","2021-09-08","2021-11-08","2021-11-09","2021-11-09","2021-11-09","2020-01-06","2020-05-18","2020-06-24","2021-08-18","2020-06-24","2020-06-24","2020-06-26","2020-07-29","2020-07-29","2021-03-23","2020-11-05","2020-06-30","2020-06-30","2020-09-23","2021-07-07","2021-07-07","2020-10-29","2020-12-11","2020-05-04","2020-05-04","2021-05-24","2021-09-08","2021-11-08","2021-05-25","2021-05-25","2020-11-05","2021-07-28","2021-08-18","2021-08-18","2021-08-18","2021-12-29","2021-12-29","2020-06-02","2020-06-02","2020-10-13","2020-10-13","2020-10-13","2020-10-13","2021-05-25","2021-06-04","2021-06-04","2021-06-04","2021-07-07","2021-10-07","2021-10-07","2019-01-09","2019-12-16","2019-03-25","2019-03-25","2019-09-03","2019-09-03","2019-01-18","2019-01-18","2019-04-18","2019-04-18","2019-04-18","2019-04-18","2019-06-05","2019-11-13","2019-11-13","2019-10-02","2019-11-18","2019-11-18","2019-11-18","2019-07-01","2019-07-01","2019-10-01","2019-12-19","2019-09-23","2019-11-11","2019-09-23","2019-09-23"],"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":{"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":[["","","VYVANSE","CAP 20MG","","Select","Select",""],["","","TRIAMT\/HCTZ","TAB 37.5-25","","Select","Select",""],["","","ONETOUCH","KIT ULTRA 2","","Select","Select",""],["","","PRODIGY","MIS 28G","","Select","Select",""],["","00555088602","ESTRADIOL","TAB 1MG","90","Select","Select",""],["","","VRAYLAR","CAP 3MG","","Select","Select",""],["","68462043630","OLMESA","TAB 5MG","60","Select","Select",""],["","68180079902","POT  CHLORIDE","CAP 10MEQ ER","60","Select","Select",""],["","65862059805","TAMSULOSIN","CAP 0.4MG","30","Select","Select",""],["","31722051901","HYDRALAZINE","TAB 10MG","180","Select","Select",""],["","00054327099","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","","FLUOXETINE","CAP 10MG","","Select","Select",""],["","","METFORMIN","TAB 500MG ER","","Select","Select",""],["","00169430313","RYBELSUS","TAB 3MG","30","Select","Select",""],["","00169413212","OZEMPIC","INJ 2\/1.5ML","2","Select","Select",""],["","45802091987","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","","OMEPRAZOLE","CAP 40MG","","Select","Select",""],["","74312015606","D3","CAP 25MCG","30","Select","Select",""],["","59267100001","PFIZER","INJ COVID-19","0","Select","Select",""],["","70370106001","INGREZZA","CAP 60MG","30","Select","Select",""],["","49281042150","FLUZONE","INJ 2021-22","0","Select","Select",""],["","00006483703","PNEUMOVAX","INJ 25\/0.5","0","Select","Select",""],["","64764073030","TRINTELLIX","TAB 10MG","30","Select","Select",""],["","","ALBUTEROL","AER HFA","","Select","Select",""],["","","HYDROXYZ","CAP 25MG","","Select","Select",""],["","00173068220","VENTOLIN","AER ","18","Select","Select",""],["","69315013601","BENZTROPINE","TAB 0.5MG","30","Select","Select",""],["","29300012810","HYDROCHLOROT","TAB 25MG","90","Select","Select",""],["","55111046705","METOPROL","TAB 50MG ER","120","Select","Select",""],["","00456111030","VIIBRYD","TAB 10MG","30","Select","Select",""],["","29300022010","MONTELUKAST","TAB 10MG","30","Select","Select",""],["","","AZITHROMYCIN","TAB 250MG","","Select","Select",""],["","00904759180","FEROSUL","TAB 325MG","30","Select","Select",""],["","67877019805","AMLODIPINE","TAB 5MG","30","Select","Select",""],["","00143924920","AMOX\/K","TAB 875-125","10","Select","Select",""],["","43547040611","CLONAZEPAM","TAB 0.5MG","15","Select","Select",""],["","","CONTOUR","TES NEXT","","Select","Select",""],["","","PEG","SOL ELECTROL","","Select","Select",""],["","","PROAIR","AER ","","Select","Select",""],["","","OXYCOD\/APAP","TAB 5-325MG","","Select","Select",""],["","","SENNA","TAB 8.6MG","","Select","Select",""],["","","IBU","TAB 800MG","","Select","Select",""],["","","FLUCONAZOLE","TAB 150MG","","Select","Select",""],["","","NITROFURANTN","CAP 100MG","","Select","Select",""],["","","NITROFUR","CAP 100MG","","Select","Select",""],["","00173060102","FLOVENT","AER 250MCG","60","Select","Select",""],["","","GAVILYTE-N","SOL FLAV PK","","Select","Select",""],["","53746010901","HYDROCO\/APAP","TAB 5-325MG","12","Select","Select",""],["","","MELATONIN","CAP 5MG","","Select","Select",""],["","","KETOROLAC","TAB 10MG","","Select","Select",""],["","","CYCLOBENZAPR","TAB 10MG","","Select","Select",""],["","68645057854","LOSARTAN","TAB 50MG","30","Select","Select",""],["","68382009810","PAROXETINE","TAB 20MG","30","Select","Select",""],["","69097012403","TOPIRAMATE","TAB 100MG","60","Select","Select",""],["","50111033401","METRONIDAZOL","TAB 500MG","21","Select","Select",""],["","55111012705","CIPROFLOXACN","TAB 500MG","20","Select","Select",""],["","00555097402","AMPHET\/DEXTR","TAB 30MG","60","Select","Select",""],["","31722017501","METHYLPHENID","TAB 20MG","60","Select","Select",""],["","65862022801","LAMOTRIGINE","TAB 100MG","30","Select","Select",""],["","00555076802","ADDERALL","TAB 30MG","60","Select","Select",""],["","50419082502","FINACEA","GEL 0.15","50","Select","Select",""],["","00143993905","AMOXICILLIN","CAP 500MG","30","Select","Select",""],["","68180071160","CEFDINIR","CAP 300MG","20","Select","Select",""],["","33332031901","AFLURIA","INJ 2019-20","0","Select","Select",""],["","67877021620","CEFUROXIME","TAB 500MG","10","Select","Select",""],["","42571025201","CLINDAMYCIN","CAP 300MG","40","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":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}