{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"B REHTAEHEMOCSNAR","gend":1,"add":"VMRAF 731DAOR ELLI","city":"MARION","state":"VA","zip":"24354-9998","dob":"1981-04-22","age":"","mstatus":"","insh":"2561210*16","cliId":"","pno":"95\/6727548-1","cno":"276\/591-8457","email":"","ename":"","eno":"","pphy":"MURPHY, GERARD H MD","ppno":"276\/646-3241","pcpadd":"403 CHILHOWIE STREET","pcpcity":"CHILHOWIE","pcpstate":"VA","pcpzip":24319,"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":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K58.0","F41.8","F10.10","M25.552","T59.91XA","I10.","F33.2","J30.2","F41.9","E87.6","K21.9","K29.00","R19.7","F41.1","F60.5","L03.012","M79.671","M25.571","S16.1XXA","NO DATA","G44.309","Y09.","K29.70","H66.92","R21.","J68.9","Z72.0","G44.319","Z88.5","Z88.8","Z79.899","Z86.69","F17.210","R51.9","R10.84","R11.2","L03.115","S49.92XA","S53.402A"],"date":["2021-01-18","2020-07-27","2020-07-27","2021-10-14","2020-11-22","2020-11-22","2020-11-22","2020-11-22","2021-12-24","2020-11-22","2020-11-22","2020-12-21","2022-03-23","2020-12-21","2020-12-21","2021-04-30","2021-11-20","2021-11-20","2021-12-24","2021-12-24","2021-12-24","2021-12-24","2022-03-22","2020-03-05","2020-03-05","2020-11-21","2020-11-21","2021-12-24","2021-12-24","2021-12-24","2021-12-24","2021-12-24","2021-12-24","2021-12-24","2022-03-23","2022-03-23","2020-09-25","2021-02-25","2021-02-25"],"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":[["","68462010530","ONDANSETRON","TAB 4MG","45","Select","Select",""],["","59762040101","SUCRALFATE","TAB 1GM","120","Select","Select",""],["","00591079501","DICYCLOMINE","TAB 20MG","20","Select","Select",""],["","00378668999","PANTOPRAZOLE","TAB 40MG","30","Select","Select",""],["","59746000103","METHYLPRED","TAB 4MG","21","Select","Select",""],["","65862044990","VALACYCLOVIR","TAB 1GM","21","Select","Select",""],["","65862017760","CEFDINIR","CAP 300MG","20","Select","Select",""],["","52817033200","CYCLOBENZAPR","TAB 10MG","20","Select","Select",""],["","50111033402","METRONIDAZOL","TAB 500MG","30","Select","Select",""],["","00228202996","ALPRAZOLAM","TAB 0.5MG","90","Select","Select",""],["","69097084805","ESCITALOPRAM","TAB 10MG","30","Select","Select",""],["","53489012002","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","27808008602","HYD","SUS 10-8\/5ML","70","Select","Select",""],["","65862001105","SERTRALINE","TAB 25MG","30","Select","Select",""],["","00591544305","PREDNISONE","TAB 20MG","10","Select","Select",""],["","65862050320","AMOX\/K","TAB 875-125","20","Select","Select",""],["","00185094097","CHOLESTYRAM","POW 4GM","378","Select","Select",""],["","00093314705","CEPHALEXIN","CAP 500MG","30","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":""}]}]}