{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"C   HPLARRJ EROOM ","gend":0,"add":"AM 031TC RON","city":"CLINTWOOD","state":"VA","zip":"24228-9998","dob":"1985-05-27","age":"","mstatus":"","insh":"24500210*34","cliId":"","pno":"12\/6725470-0","cno":"276\/210-0745","email":"","ename":"","eno":"","pphy":"LESTER, KAREN L NP","ppno":"276\/415-9600","pcpadd":"754 E MAIN ST","pcpcity":"LEBANON","pcpstate":"VA","pcpzip":24266,"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":["F31.9","F11.20","B18.2","F17.211","F17.200","J30.2","F10.20","K21.9","K30.","G62.9","B37.0","K13.79","Z79.891","L02.413","L03.113","Z79.899","R10.11","K59.00","R11.2","I10."],"date":["2022-06-27","2022-11-15","2020-06-04","2020-05-07","2022-11-09","2022-11-01","2022-11-01","2022-11-01","2022-11-01","2022-11-01","2022-11-09","2022-11-09","2020-06-04","2020-07-22","2020-07-22","2022-06-27","2021-09-18","2021-09-18","2021-09-18","2021-09-18"],"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","28","Select","Select",""],["","50228017805","GABAPENTIN","TAB 800MG","90","Select","Select",""],["","55111015905","OMEPRAZOLE","CAP 40MG","56","Select","Select",""],["","43598058230","BUPREN\/NALOX","MIS 8-2MG","14","Select","Select",""],["","53885000810","ONETOUCH","MIS PLUS 33G","100","Select","Select",""],["","11877001140","BINAXNOW","KIT HOME TES","2","Select","Select",""],["","43547035311","LISINOPRIL","TAB 10MG","28","Select","Select",""],["","29300039710","AMLODIPINE","TAB 5MG","14","Select","Select",""],["","00002822259","INSULIN","INJ 100\/ML","3","Select","Select",""],["","08290320550","BD  PEN NEEDL","MIS 32GX4MM","100","Select","Select",""],["","99073070827","FREESTYLE    TES LITE","TES LITE","100","Select","Select",""],["","99073070805","FREESTYLE    KIT LITE","KIT LITE","1","Select","Select",""],["","00006505506","LAGEVRIO","CAP 200MG","40","Select","Select",""],["","57237000511","FLUCONAZOLE","TAB 150MG","2","Select","Select",""],["","68382070718","DOXYCYC","CAP 100MG","14","Select","Select",""],["","08290236850","LACTINEX","CHW ","14","Select","Select",""],["","69547035302","NARCAN","SPR ","2","Select","Select",""],["","10939031544","ACIDOPHILUS","CAP 10MG","14","Select","Select",""],["","69230031703","ALLERGY","TAB 10MG","28","Select","Select",""],["","57237007710","ONDANSETRON","TAB 4MG ODT","20","Select","Select",""],["","62332000271","FAMOTIDINE","TAB 40MG","14","Select","Select",""],["","37205027510","BACITRACIN","OIN 500\/GM","30","Select","Select",""],["","33342002332","LEVOFLOXACIN","TAB 750MG","14","Select","Select",""],["","57237023301","SMZ-TMP","TAB 800-160","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":""}]}]}